Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.

<h4>Background</h4>Tranexamic acid (TXA) is well-established as a versatile oral, intramuscular, and intravenous (IV) antifibrinolytic agent. However, the efficacy of IV TXA in reducing perioperative blood transfusion in spinal surgery is poorly documented.<h4>Methodology</h4>...

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Autores principales:	Baohui Yang, Haopeng Li, Dong Wang, Xijing He, Chun Zhang, Pinglin Yang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5106c3c95c734d26a5e26e3fe260850e
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spelling	oai:doaj.org-article:5106c3c95c734d26a5e26e3fe260850e2021-11-18T07:57:57ZSystematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.1932-620310.1371/journal.pone.0055436https://doaj.org/article/5106c3c95c734d26a5e26e3fe260850e2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23424632/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Tranexamic acid (TXA) is well-established as a versatile oral, intramuscular, and intravenous (IV) antifibrinolytic agent. However, the efficacy of IV TXA in reducing perioperative blood transfusion in spinal surgery is poorly documented.<h4>Methodology</h4>We conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-randomized (qi-RCTs) trials that included patients for various spinal surgeries, such as adolescent scoliosis surgery administered with perioperative IV TXA according to Cochrane Collaboration guidelines using electronic PubMed, Cochrane Central Register of Controlled Trials, and Embase databases. Additional journal articles and conference proceedings were manually located by two independent researchers.<h4>Results</h4>Totally, nine studies were included, with a total sample size of 581 patients. Mean blood loss was decreased in patients treated with perioperative IV TXA by 128.28 ml intraoperatively (ranging from 33.84 to 222.73 ml), 98.49 ml postoperatively (ranging from 83.22 to 113.77 ml), and 389.21 ml combined (ranging from 177.83 to 600.60 ml). The mean volume of transfused packed cells were reduced by 134.55 ml (ranging 51.64 to 217.46) (95% CI; P = 0.0001). Overall, the number of patients treated with TXA who required blood transfusions was lower by 35% than that of patients treated with the comparator and who required blood transfusions (RR 0.65; 95% CI; 0.53 to 0.85; P<0.0001, I(2) = 0%). A dose-independent beneficial effect of TXA was observed, and confirmed in subgroup and sensitivity analyses. A total of seven studies reported DVT data. The study containing only a single DVT case was not combined.<h4>Conclusions</h4>The blood loss was reduced in spinal surgery patients with perioperative IV TXA treatment. Also the percentage of spinal surgery patients who required blood transfusion was significantly decreased. Further evaluation is required to confirm our findings before TXA can be safely used in patients undergoing spine surgery.Baohui YangHaopeng LiDong WangXijing HeChun ZhangPinglin YangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e55436 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Baohui Yang Haopeng Li Dong Wang Xijing He Chun Zhang Pinglin Yang Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
description	<h4>Background</h4>Tranexamic acid (TXA) is well-established as a versatile oral, intramuscular, and intravenous (IV) antifibrinolytic agent. However, the efficacy of IV TXA in reducing perioperative blood transfusion in spinal surgery is poorly documented.<h4>Methodology</h4>We conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-randomized (qi-RCTs) trials that included patients for various spinal surgeries, such as adolescent scoliosis surgery administered with perioperative IV TXA according to Cochrane Collaboration guidelines using electronic PubMed, Cochrane Central Register of Controlled Trials, and Embase databases. Additional journal articles and conference proceedings were manually located by two independent researchers.<h4>Results</h4>Totally, nine studies were included, with a total sample size of 581 patients. Mean blood loss was decreased in patients treated with perioperative IV TXA by 128.28 ml intraoperatively (ranging from 33.84 to 222.73 ml), 98.49 ml postoperatively (ranging from 83.22 to 113.77 ml), and 389.21 ml combined (ranging from 177.83 to 600.60 ml). The mean volume of transfused packed cells were reduced by 134.55 ml (ranging 51.64 to 217.46) (95% CI; P = 0.0001). Overall, the number of patients treated with TXA who required blood transfusions was lower by 35% than that of patients treated with the comparator and who required blood transfusions (RR 0.65; 95% CI; 0.53 to 0.85; P<0.0001, I(2) = 0%). A dose-independent beneficial effect of TXA was observed, and confirmed in subgroup and sensitivity analyses. A total of seven studies reported DVT data. The study containing only a single DVT case was not combined.<h4>Conclusions</h4>The blood loss was reduced in spinal surgery patients with perioperative IV TXA treatment. Also the percentage of spinal surgery patients who required blood transfusion was significantly decreased. Further evaluation is required to confirm our findings before TXA can be safely used in patients undergoing spine surgery.
format	article
author	Baohui Yang Haopeng Li Dong Wang Xijing He Chun Zhang Pinglin Yang
author_facet	Baohui Yang Haopeng Li Dong Wang Xijing He Chun Zhang Pinglin Yang
author_sort	Baohui Yang
title	Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
title_short	Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
title_full	Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
title_fullStr	Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
title_full_unstemmed	Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
title_sort	systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/5106c3c95c734d26a5e26e3fe260850e
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Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery.

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