Sex discrimination after injury: is inequity in tranexamic acid administration just the tip of the iceberg?

There is emerging evidence of inequalities in healthcare provision between women and men. Trauma care is no exception with a number of studies indicating lower levels of prioritisation for injured female patients. The anti-fibrinolytic drug tranexamic acid, reduced trauma deaths to a similar extent in females and males in the international Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH) randomised controlled trials, but in real-world practice, national registry data shows females are less likely to receive tranexamic acid than males. Inequity in the provision of tranexamic acid may extend beyond sex (and gender), and further study is required to examine the effect of age and mechanism of injury differences between men and women in the decision to treat.

Automated summary

Emerging evidence suggests inequalities in healthcare provision between women and men, including in trauma care. While an anti-fibrinolytic drug showed similar effects in reducing trauma deaths for both sexes, real-world data indicates that females are less likely to receive this treatment compared to males. Further research is needed to examine the impact of age and injury mechanisms on the decision to treat.