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

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.