17th November 2019

Wales takes part in global study to save thousands of patients with brain injuries

A hospital in north Wales took part in the largest ever study to be conducted into traumatic brain injury, alongside over 170 other hospitals from 29 countries, which found that a cheap and widely available drug could save thousands of lives a year.

Anyone could experience a fall, car crash or assault at any time, events that can lead to brain trauma with devastating consequences. Every year in the UK over one million people will attend emergency rooms with a recent head injury, and across Europe about 57,000 patients will die from their injuries, with survivors having to live with permanent disabilities.

The study, Clinical Randomisation of an Antifibrinolytic in Significant Head Injury (CRASH-3), found that if doctors gave patients tranexamic acid within three hours of injury the number of deaths in traumatic brain injury patients could be reduced by as much as 20 percent.

Tranexamic acid works by helping to stop bleeding in and around the brain when blood vessels have been torn. Positive effects from this form of treatment were greatest in patients with mild and moderate brain injury, with no evidence of adverse effects and no increase in disability.

Patients were recruited to Ysbyty Gwynedd, Bangor, where research staff gave them either a Tranexamic acid injection or a ‘dummy injection’ called a placebo to monitor whether or not the drug had any affect. Both patients and staff were unaware of which injection had been given.

Dr Rob Perry, consultant in emergency medicine, emergency department clinician and principal investigator for the CRASH-3 study at Ysbyty Gwynedd, said, “This study was really important because we wanted to know whether giving a cheap and safe drug would improve survival for patients with isolated head injuries, as we already know it does in patients with multiple injuries.

“I’m delighted that Ysbyty Gwynedd was able to take part, and indeed to recruit the only patients from Wales in the study.”

This form of treatment is not effective for everyone, researchers saw no benefit to patients with severe trauma. Once bleeding in the brain has happened, the tranexamic acid cannot undo it. There is a narrow window of opportunity to give the drug before the bleeding becomes untreatable.

Results from CRASH-3 show one of first treatments found to be beneficial for patients with traumatic brain injury. This effective, widely available and affordable treatment could save many thousands of lives and could reduce disability following injury.

Read more about the study in The Lancet, where it was published last month.