Is Tranexamic Acid Beneficial in Open Spine Surgery ? and its Effects Vary by Dosage, Age, Sites, and Locations: A Meta-Analysis of Randomized Controlled Trials
The role of tranexamic acid (TXA) in controlling blood loss during spine surgery remains unclear. With the publication of new randomized controlled trials (RCTs), we conducted a meta-analysis to determine the safety and efficacy of TXA in spine surgery. PubMed, Embase, Web of Science, and Cochrane d...
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| Veröffentlicht in: | World neurosurgery 2022-10, Vol.166, p.141-152 |
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| creator | Liu, Zhen-Gang Yang, Fan Zhu, Yu-Hang Liu, Guang-Chen Zhu, Qing-San Zhang, Bo-Yin |
| description | The role of tranexamic acid (TXA) in controlling blood loss during spine surgery remains unclear. With the publication of new randomized controlled trials (RCTs), we conducted a meta-analysis to determine the safety and efficacy of TXA in spine surgery.
PubMed, Embase, Web of Science, and Cochrane databases were searched for relevant studies through 2022. Only RCTs were eligible for this study. The extracted data were analyzed using RevMan 5.3 software for meta-analysis.
Twenty RCTs including 1497 patients undergoing spine surgery were included in this systematic evaluation. Compared with the control group, TXA significantly reduced total blood loss (mean difference [MD] = – 218.96, 95% confidence interval [CI] = – 309.77 to – 128.14, P |
| doi_str_mv | 10.1016/j.wneu.2022.07.044 |
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PubMed, Embase, Web of Science, and Cochrane databases were searched for relevant studies through 2022. Only RCTs were eligible for this study. The extracted data were analyzed using RevMan 5.3 software for meta-analysis.
Twenty RCTs including 1497 patients undergoing spine surgery were included in this systematic evaluation. Compared with the control group, TXA significantly reduced total blood loss (mean difference [MD] = – 218.96, 95% confidence interval [CI] = – 309.77 to – 128.14, P < 0.00001), perioperative blood loss (MD = – 90.54, 95% CI = – 139.33 to – 41.75, P = 0.0003), postoperative drainage (MD = – 102.60, 95% CI = – 139.51 to – 65.70, P < 0.00001)，reduced hospital stay (MD = – 1.42, 95% CI = – 2.71 to – 0.14, P = 0.03), reduced total blood transfusion volume (MD = – 551.06, 95% CI = – 755.90 to – 346.22, P < 0.00001), and international normalized ratio (MD = −0.03, 95% CI = −0.04 to −0.02, P < 0.00001).
Based on the meta-analysis of 20 RCTs, we demonstrated that TXA reduces blood loss in open spine surgery, decreases transfusion rates, and shortens hospital stays. The TXA administration during the perioperative period does not increase the incidence of postoperative complications.</description><identifier>ISSN: 1878-8750</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2022.07.044</identifier><identifier>PMID: 35843575</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Antifibrinolytic Agents - therapeutic use ; Blood loss ; Blood Loss, Surgical - prevention & control ; Humans ; Meta-analysis ; Randomized controlled trial ; Randomized Controlled Trials as Topic ; Spinal Dysraphism ; Spine surgery ; Tranexamic acid ; Tranexamic Acid - therapeutic use</subject><ispartof>World neurosurgery, 2022-10, Vol.166, p.141-152</ispartof><rights>2022</rights><rights>Copyright © 2022. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c271t-50cb4077c7890e9606fbe9c83a23622fa09df5c5b02140cf4a8c8274f51f70b33</citedby><cites>FETCH-LOGICAL-c271t-50cb4077c7890e9606fbe9c83a23622fa09df5c5b02140cf4a8c8274f51f70b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1878875022009925$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35843575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Zhen-Gang</creatorcontrib><creatorcontrib>Yang, Fan</creatorcontrib><creatorcontrib>Zhu, Yu-Hang</creatorcontrib><creatorcontrib>Liu, Guang-Chen</creatorcontrib><creatorcontrib>Zhu, Qing-San</creatorcontrib><creatorcontrib>Zhang, Bo-Yin</creatorcontrib><title>Is Tranexamic Acid Beneficial in Open Spine Surgery ? and its Effects Vary by Dosage, Age, Sites, and Locations: A Meta-Analysis of Randomized Controlled Trials</title><title>World neurosurgery</title><addtitle>World Neurosurg</addtitle><description>The role of tranexamic acid (TXA) in controlling blood loss during spine surgery remains unclear. With the publication of new randomized controlled trials (RCTs), we conducted a meta-analysis to determine the safety and efficacy of TXA in spine surgery.
PubMed, Embase, Web of Science, and Cochrane databases were searched for relevant studies through 2022. Only RCTs were eligible for this study. The extracted data were analyzed using RevMan 5.3 software for meta-analysis.
Twenty RCTs including 1497 patients undergoing spine surgery were included in this systematic evaluation. Compared with the control group, TXA significantly reduced total blood loss (mean difference [MD] = – 218.96, 95% confidence interval [CI] = – 309.77 to – 128.14, P < 0.00001), perioperative blood loss (MD = – 90.54, 95% CI = – 139.33 to – 41.75, P = 0.0003), postoperative drainage (MD = – 102.60, 95% CI = – 139.51 to – 65.70, P < 0.00001)，reduced hospital stay (MD = – 1.42, 95% CI = – 2.71 to – 0.14, P = 0.03), reduced total blood transfusion volume (MD = – 551.06, 95% CI = – 755.90 to – 346.22, P < 0.00001), and international normalized ratio (MD = −0.03, 95% CI = −0.04 to −0.02, P < 0.00001).
Based on the meta-analysis of 20 RCTs, we demonstrated that TXA reduces blood loss in open spine surgery, decreases transfusion rates, and shortens hospital stays. The TXA administration during the perioperative period does not increase the incidence of postoperative complications.</description><subject>Antifibrinolytic Agents - therapeutic use</subject><subject>Blood loss</subject><subject>Blood Loss, Surgical - prevention & control</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Randomized controlled trial</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Spinal Dysraphism</subject><subject>Spine surgery</subject><subject>Tranexamic acid</subject><subject>Tranexamic Acid - therapeutic use</subject><issn>1878-8750</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhiMEolXpC3BAPnJoUttxYgchobAtpdJWldiFq-U448qrxN7aCbB9Gh4VL1t6rA-ekfXNr_H_Z9lbgguCSX2-KX45mAuKKS0wLzBjL7JjIrjIBa-bl099hY-y0xg3OJ2SMMHL19lRWQlWVrw6zv5cR7QOysFvNVqNWm179BkcGKutGpB16HYLDq221gFazeEOwg59Qsr1yE4RXRoDOtUfKj13O3Tho7qDM9Tur5WdIJ79Y5deq8l6Fz-gFt3ApPLWqWEXbUTeoG8J8aN9gB4tvJuCH4bUrkPaIL7JXplU4PSxnmTfv1yuF1_z5e3V9aJd5ppyMuUV1h3DnGsuGgxNjWvTQaNFqWhZU2oUbnpT6arDlDCsDVNCC8qZqYjhuCvLk-z9QXcb_P0McZKjjRqGIXnj5yhp3RBWs7oSCaUHVAcfYwAjt8GOyQFJsNyHIzdyH47chyMxlymcNPTuUX_uRuifRv5HkYCPBwDSL39aCDJqC05Db0PyWPbePqf_Fw2wn8s</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Liu, Zhen-Gang</creator><creator>Yang, Fan</creator><creator>Zhu, Yu-Hang</creator><creator>Liu, Guang-Chen</creator><creator>Zhu, Qing-San</creator><creator>Zhang, Bo-Yin</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202210</creationdate><title>Is Tranexamic Acid Beneficial in Open Spine Surgery ? and its Effects Vary by Dosage, Age, Sites, and Locations: A Meta-Analysis of Randomized Controlled Trials</title><author>Liu, Zhen-Gang ; Yang, Fan ; Zhu, Yu-Hang ; Liu, Guang-Chen ; Zhu, Qing-San ; Zhang, Bo-Yin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-50cb4077c7890e9606fbe9c83a23622fa09df5c5b02140cf4a8c8274f51f70b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antifibrinolytic Agents - therapeutic use</topic><topic>Blood loss</topic><topic>Blood Loss, Surgical - prevention & control</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Randomized controlled trial</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Spinal Dysraphism</topic><topic>Spine surgery</topic><topic>Tranexamic acid</topic><topic>Tranexamic Acid - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Zhen-Gang</creatorcontrib><creatorcontrib>Yang, Fan</creatorcontrib><creatorcontrib>Zhu, Yu-Hang</creatorcontrib><creatorcontrib>Liu, Guang-Chen</creatorcontrib><creatorcontrib>Zhu, Qing-San</creatorcontrib><creatorcontrib>Zhang, Bo-Yin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>World neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Zhen-Gang</au><au>Yang, Fan</au><au>Zhu, Yu-Hang</au><au>Liu, Guang-Chen</au><au>Zhu, Qing-San</au><au>Zhang, Bo-Yin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is Tranexamic Acid Beneficial in Open Spine Surgery ? and its Effects Vary by Dosage, Age, Sites, and Locations: A Meta-Analysis of Randomized Controlled Trials</atitle><jtitle>World neurosurgery</jtitle><addtitle>World Neurosurg</addtitle><date>2022-10</date><risdate>2022</risdate><volume>166</volume><spage>141</spage><epage>152</epage><pages>141-152</pages><issn>1878-8750</issn><eissn>1878-8769</eissn><abstract>The role of tranexamic acid (TXA) in controlling blood loss during spine surgery remains unclear. With the publication of new randomized controlled trials (RCTs), we conducted a meta-analysis to determine the safety and efficacy of TXA in spine surgery.
PubMed, Embase, Web of Science, and Cochrane databases were searched for relevant studies through 2022. Only RCTs were eligible for this study. The extracted data were analyzed using RevMan 5.3 software for meta-analysis.
Twenty RCTs including 1497 patients undergoing spine surgery were included in this systematic evaluation. Compared with the control group, TXA significantly reduced total blood loss (mean difference [MD] = – 218.96, 95% confidence interval [CI] = – 309.77 to – 128.14, P < 0.00001), perioperative blood loss (MD = – 90.54, 95% CI = – 139.33 to – 41.75, P = 0.0003), postoperative drainage (MD = – 102.60, 95% CI = – 139.51 to – 65.70, P < 0.00001)，reduced hospital stay (MD = – 1.42, 95% CI = – 2.71 to – 0.14, P = 0.03), reduced total blood transfusion volume (MD = – 551.06, 95% CI = – 755.90 to – 346.22, P < 0.00001), and international normalized ratio (MD = −0.03, 95% CI = −0.04 to −0.02, P < 0.00001).
Based on the meta-analysis of 20 RCTs, we demonstrated that TXA reduces blood loss in open spine surgery, decreases transfusion rates, and shortens hospital stays. The TXA administration during the perioperative period does not increase the incidence of postoperative complications.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35843575</pmid><doi>10.1016/j.wneu.2022.07.044</doi><tpages>12</tpages></addata></record> |
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| subjects | Antifibrinolytic Agents - therapeutic use Blood loss Blood Loss, Surgical - prevention & control Humans Meta-analysis Randomized controlled trial Randomized Controlled Trials as Topic Spinal Dysraphism Spine surgery Tranexamic acid Tranexamic Acid - therapeutic use |
| title | Is Tranexamic Acid Beneficial in Open Spine Surgery ? and its Effects Vary by Dosage, Age, Sites, and Locations: A Meta-Analysis of Randomized Controlled Trials |
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