Methodology: 3.5/5
Usefulness: 3.5/5

The CRASH-3 trial collaborators. The Lancet. 2019 Oct 14. Online First

Editorial: CRASH-3: a win for patients with traumatic brain injury

Question and Methods: Multi-centre, randomized, placebo-controlled trial looking at whether TXA (1g over 10 minutes followed by infusion over 8 hours) reduces mortality in patients with ICH.

Findings: No difference in mortality in TXA vs. placebo group, however, sub-analysis saw improvement in mortality in the mild-to-moderate injury group (RR 0.78, NNT 59).

Limitations: Protocol change in middle of study for TXA administered from within 8 hours to within 3 hours.

Interpretation: TXA does not reduce head-injury mortality in ICH, however, may be beneficial in mild-to-moderate head injury although this was not the primary outcome.

By: Dr. Garrick Mok