Does tranexamic acid reduce mortality from acute traumatic brain injury?

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Why is this study important?

Traumatic brain injury (TBI) is a major cause of mortality and morbidity especially among young people in lower income countries. Most TBI patients have intracranial hemorrhage (ICH) and hematoma expansion portends a poor prognosis and death. Tranexamic acid (TXA) is a safe and effective antifibrinolytic agent with many clinical indications and evidence for improving outcomes in patients with known or suspected significant hemorrhage.[1] The administration of TXA in the emergency department (ED) is simple, rapid and inexpensive but its role in TBI management is still controversial. This is a systematic review and meta-analysis of the collective evidence for TXA in the management of TBI.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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