Early TXA for Traumatic Brain Injury in Military Patients Tied to Full Employment

army soldiers
army soldiers
Presenting at the 2022 AAN Annual Meeting, a researcher evaluated employability after TBI among nonmoribund, military age patients who received tranexamic acid within hours after their injury.

The following article is part of conference coverage from the 2022 American Academy of Neurology (AAN) Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the 2022 AAN Annual Meeting.


Administration of tranexamic acid (TXA) within 1 hour of a traumatic brain injury (TBI) may increase the likelihood of returning the patient with TBI to full employability and may help sustain combat power of the Military, according to study results presented at the 2022 American Academy of Neurology (AAN) Annual Meeting, held from April 2 to April 7 in Seattle, Washington, and virtually from April 24-26, 2022.

A subgroup analysis from the CRASH-3 trial found that early administration of TXA within 3 hours of a TBI had a mortality benefit among patients with post-TBI nonmoribund injuries. Another study found a trend towards decreased mortality with 2-hour administration of TXA after a TBI. However, these studies did not include data on employability following a TBI.

The current study sought to evaluate employability after TBI among nonmoribund, military age patients. Data from the CRASH-3 study (N=12,658) were matched with the United States (US) Military population (N=6661) who had a TBI. Features of TBI (Glasgow Coma Scale [GCS] and systolic blood pressure) were assessed on the basis of receiving TXA within 1 or 3 hours after TBI. The primary outcomes were days in the intensive care unit (ICU) and whether the patient returned to full employability.

The patients who received TXA within 1 and 3 hours after TBI comprised each of 83% men; aged mean 29 and 30 years, respectively; systolic blood pressure of 123 mmHg; and a mean GCS 10 points in each group.

TXA administration within 1 hour was associated with significant decrease in days spent in the ICU (mean, -0.8 days; P =.04) and an increased the likelihood of return to full employability (odds ratio [OR], 1.66; P =.006).

This study was limited by combining data from a clinical trial with real-world patient data from the Military.

The researcher concluded that “this post-hoc analysis suggests that TXA administration within 1 hour of TBI in non-moribund military age patients could increase the odds of return to full employability; and possibly help sustain combat power for the Military.”


Holtkamp M. Does Tranexamic Acid (TXA) post Traumatic Brain Injury (TBI) return Service Members to the Battlefield? Presented at: the 2022 AAN Annual Meeting; April 2-7, 2022; Seattle, Washington; April 24-26, 2022; Virtual Meeting. Abstract P10.001.