Tranexamic acid and the risk of delirium after isolated “on-pump” coronary artery bypass grafting: A propensity score modeled analysis in 3392 patients

[...]the neurotoxic effect of TXA is not only limited to CS [3,4], but also leads to delirium [8]. Based on these results, we conclude that in patients undergoing isolated on-pump CABG, even a moderate dose of TXA is associated with a significantly increased risk of delirium. [...]even a moderate dose of TXA should be given with caution.Funding This study was partly financed by the research fund of the Institute of Anesthesiology and Pain Therapy, Herz- und Diabeteszentrum NRW, Ruhr-University Bochum, Germany.Author contribution NH and AK designed the study. Parameter With TXA treatment Without TXA treatment P-value (n = 2546) (n = 846) Age (years)a 69 (61;75) 69 (61;74) 0.09 Sex, Malesb 210 (79.1) 650 (76.8) 0.18 Body Mass Index (kg/m2)a 27.8 (25.2;31.0) 27.8 (25.0;30.8) 0.98 Diabetes Mellitusb 940 (37.0) 320 (37.8) 0.68 Hypertensionb 2171 (85.4) 733 (86.6) 0.4 Strokeb 118 (4.6) 27 (3.2) 0.08 Myocardial Infarctionb 1109 (43.6) 315 (37.2) 0.001 Chronic Obstructive Pulmonary Diseaseb 246 (9.7) 78 (9.2) 0.74 Left Ventricular Ejection Fraction (%)a 55 (40;60) 56 (45;60) 50%b 253 (10.0) 70 (8.3) 0.16 Euroscore II (%)a 2.3 (1.2;5.5) 1.8 (1.1;4.1)