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If TXA is given more than 3\u2009h after traumatic injury, there is a significant and paradoxical increased risk of death due to bleeding. TXA has level 1 evidence for use as a bleeding reduction agent in isolated orthopedic operations, but in polytrauma patients undergoing orthopedic operations, it is not clear if and when TXA is safe or effective once outside the 3\u2010h window of proven trauma efficacy.<\/jats:p>","DOI":"10.1111\/trf.17779","type":"journal-article","created":{"date-parts":[[2024,3,10]],"date-time":"2024-03-10T13:38:16Z","timestamp":1710077896000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Tranexamic acid in trauma: After 3 hours from injury, when is it safe and effective to use again?"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-8155","authenticated-orcid":false,"given":"Christopher D.","family":"Barrett","sequence":"first","affiliation":[{"name":"Department of Surgery University of Nebraska Medical Center  Omaha Nebraska USA"},{"name":"Department of Cellular and Integrative Physiology University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan G.","family":"Schoenecker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Medcalf","sequence":"additional","affiliation":[{"name":"Australian Centre for Blood Diseases Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3324-5456","authenticated-orcid":false,"given":"Paul S.","family":"Myles","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Perioperative Medicine Alfred Hospital and Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.2302\/kjm.11.105"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60835-5"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.4350"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.05.058"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew434"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31829a0ac7"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60278-X"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-08-588442"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002092"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1702169"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1586227"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000092"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.17779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T11:24:02Z","timestamp":1715253842000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.17779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,10]]},"references-count":12,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/trf.17779"],"URL":"https:\/\/doi.org\/10.1111\/trf.17779","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,10]]},"assertion":[{"value":"2023-11-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}