Tranexamic Acid Administration is Associated With an Increased Risk of Post-Traumatic Venous Thromboembolism

Background Tranexamic acid (TXA) is used as a hemostatic adjunct for hemorrhage control in the injured patient and reduces early preventable death. But the risk of venous thromboembolism (VTE) has been incompletely explored. Previous studies investigating the effect of TXA on VTE vary in their findings. We performed a propensity matched analysis to investigate the association between TXA and VTE following trauma, hypothesizing that TXA is an independent risk factor for VTE. Methods This retrospective study queried trauma patients presenting to a single level I trauma center from 2012 to 2016. Our primary outcome was composite pulmonary embolism or deep vein thrombosis. Mortality, transfusion, ICU and hospital lengths of stay (LOS) were secondary outcomes. Propensity matched mixed effects multivariate logistic regression was used to determine adjusted odds ratio (aOR) and 95% confidence intervals of TXA on outcomes of interest, adjusting for prespecified confounders. Competing risks regression assessed subdistribution hazard ratio (SHR) of VTE after accounting for mortality. Results Out of 21,931 patients, 189 pairs were well matched across propensity score variables (standardized differences

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