Traumatic bleeding to be the leading cause of early mortality in injured patients. Based on the previous studies tranexamic acid (TXA) reported to be efficiently controlling bleeding at early stage post trauma. But due to lacking of published randomized control studies, its effectiveness in pre-hospital settings remains unclear. Therefore, in the current research, it was demonstrated that prehospital TXA appears to reduce early mortality in trauma patients. 

Antifibrinolytic agent Tranexamic acid (TXA) has a possible clinical advantage for in-hospital patients with severe bleeding; however its efficacy in pre-hospital settings remains uncertain. This systematic review and meta-analysis assess whether pre-hospital administration of TXA improved patients' outcomes compared to placebo?

Retrospective, randomised (RCT) or quasi-RCT, prospective studies were searched from databases like Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry Platform, Google Scholar, MEDLINE, Scopus, PubMed, and clinicaltrials.gov to compare impact of prehospital administration of TXA and placebo on the outcomes of trauma patients with notable haemorrhage. In-hospital thromboembolic complications and 24 hours 30-day mortality were taken as the main outcomes. Data were abstracted independently by two authors by applying a data collection form. When suitable, findings from several studies were pooled for the analysis.

Two analytical studies matched the inclusion criteria. The impact of TXA on 24-hour mortality had a pooled odds ratio (OR) of 0.49, 30-day mortality OR of 0.86, and thromboembolic events OR of 0.74.

Prehospital TXA decreased early mortality among trauma patients. Further randomised controlled clinical trials are required to evaluate the significance of these outcomes.