{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:41:49Z","timestamp":1773009709768,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traumatic brain injury (TBI) and hemorrhage are leading causes of trauma death and disability worldwide. The concurrence of hemorrhage and brain injury carries a two\u2010fold increase in mortality and clinical management of patients with concurrent TBI and hemorrhage is challenging. Tranexamic acid (TXA) has been shown to reduce mortality from hemorrhage and TBI independently, however there is sparse evidence on the potential benefit of TXA in patients with both non\u2010head hemorrhage and TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary database analysis of EpiC, a multicenter, prospective cohort of trauma patients in South Africa. We compared the morbidity and mortality of patients experiencing both non\u2010head hemorrhage and TBI who received TXA within 3\u2010h post\u2010injury versus similarly injured patients who did not receive TXA. Inverse probability treatment weighting (IPTW) was implemented followed by a multivariable logistic regression to evaluate 7\u2010day mortality. Secondary outcomes included the worst 7\u2010day sequential organ failure assessment (SOFA) and neurologic recovery assessed by Glasgow Outcomes Score Extended (GOSE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 656 patients were included in the analysis. 132 (20%) received TXA within\u00a03\u00a0h and 544 (80%) did not. For the primary outcome of 7\u2010day mortality, treatment with TXA was associated with a 22% reduction in odds of death (mOR, 0.78, 95% CI, 0.62\u20130.98). TXA\u2010treated patients had significant lower odds of SOFA &gt;\u00a04 or death (mOR, 0.71; 95%CI, 0.53\u20130.95) and non\u2010significantly reduced odds of poor functional status at 3\u00a0months (GOSE &lt;\u00a07 or death) (mOR, 0.89; 95% CI, 0.68\u20131.18). Treatment with TXA within 2\u00a0h was associated with a 27% reduction in odds of 7\u2010day mortality (mOR, 0.73; 95%CI, 0.61\u20130.86).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study, the administration of TXA within 3\u00a0h to patients with concurrent hemorrhage and TBI was associated with a 22% reduction in mortality at 7\u00a0days. The mortality benefit was slightly larger when TXA was given within 2\u00a0h. TXA treatment was also associated with lower risk of organ failure. These results support a growing body of evidence that TXA is an effective intervention to reduce mortality and morbidity after traumatic injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70161","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T07:55:18Z","timestamp":1764402918000},"page":"233-243","source":"Crossref","is-referenced-by-count":0,"title":["Mortality Benefit of Tranexamic Acid for Hemorrhage With Concurrent Traumatic Brain Injury: Outcomes From a Prospective Cohort Study in a High\u2010Trauma, Prolonged Care Setting"],"prefix":"10.1002","volume":"50","author":[{"given":"Julia M.","family":"Dixon","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine School of Medicine University of Colorado, Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adane F.","family":"Wogu","sequence":"additional","affiliation":[{"name":"Department of 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J.","family":"Lategan","sequence":"additional","affiliation":[{"name":"Division of Surgery Department of Surgical Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Oosthuizen","sequence":"additional","affiliation":[{"name":"Division of Surgery Department of Surgical Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janette","family":"Verster","sequence":"additional","affiliation":[{"name":"Division of Forensic Medicine, Department of Pathology Stellenbosch University  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaheem","family":"de Vries","sequence":"additional","affiliation":[{"name":"Collaborative for Emergency Care in Africa  Cape Town South 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