Evaluation of the use of tranexamic acid in the postoperative period in patients with scoliosis undergoing posterior fusion
Scoliosis is the most prevalent type of spinal deformity, with a 2–3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complication...
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| Veröffentlicht in: | Neurosurgical review 2024-08, Vol.47 (1), p.416, Article 416 |
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| creator | Carvalho, Alexandry da Luz Silva, Indira da Cruz Neto, Paulo Rodrigues Pokorny, Gabriel Amaral, Rodrigo Pratali, Raphael Acácio, Ricardo Romeiro, Carlos Magno, Marcus Vinicius Daher, Murilo Herrero, Carlos Fernando P. S. |
| description | Scoliosis is the most prevalent type of spinal deformity, with a 2–3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complications. Several antifibrinolytic drugs, such as tranexamic acid, have been regarded as safe and effective options for reducing blood loss. Therefore, the present study aimed to analyse the effectiveness of this drug for controlling bleeding when used intraoperatively and in the first 48 h after surgery. A prospective randomized study of a cohort of patients included in a mass event for scoliosis treatment using PSF was performed. Twenty-eight patients were analysed and divided into two groups: 14 patients were selected for intraoperative and postoperative use of tranexamic acid (TXA), and the other 14 were selected only during the intraoperative period. The drainage bleeding rate, length of hospital stay, number of transfused blood units, and rate of adverse clinical effects were compared. All the patients involved had similar numbers of fusion levels addressed and similar scoliosis profiles. The postoperative bleeding rate through the drain did not significantly differ between the two groups (
p
> 0.05). There was no significant difference in the number of transfused blood units between the groups (
p
= 0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically significant difference. Furthermore, the groups had similar adverse effects (
p
= 0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group. No significant differences were found in the use of TXA during the first 48 postoperative hours or in postoperative outcomes. |
| doi_str_mv | 10.1007/s10143-024-02599-3 |
| format | Article |
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p
> 0.05). There was no significant difference in the number of transfused blood units between the groups (
p
= 0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically significant difference. Furthermore, the groups had similar adverse effects (
p
= 0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group. No significant differences were found in the use of TXA during the first 48 postoperative hours or in postoperative outcomes.</description><identifier>ISSN: 1437-2320</identifier><identifier>EISSN: 1437-2320</identifier><identifier>DOI: 10.1007/s10143-024-02599-3</identifier><identifier>PMID: 39122900</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Antifibrinolytic Agents - therapeutic use ; Blood Loss, Surgical - prevention & control ; Blood Transfusion - statistics & numerical data ; Female ; Humans ; Length of Stay ; Male ; Medicine ; Medicine & Public Health ; Neurosurgery ; Postoperative Hemorrhage - epidemiology ; Postoperative Period ; Prospective Studies ; Scoliosis - surgery ; Spinal Fusion - adverse effects ; Spinal Fusion - methods ; Tranexamic Acid - therapeutic use ; Treatment Outcome ; Young Adult</subject><ispartof>Neurosurgical review, 2024-08, Vol.47 (1), p.416, Article 416</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c272t-883658341581ad2a721ac752411dc93a4321cd93302904ae4be3418a85255b3a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10143-024-02599-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10143-024-02599-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39122900$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carvalho, Alexandry</creatorcontrib><creatorcontrib>da Luz Silva, Indira</creatorcontrib><creatorcontrib>da Cruz Neto, Paulo Rodrigues</creatorcontrib><creatorcontrib>Pokorny, Gabriel</creatorcontrib><creatorcontrib>Amaral, Rodrigo</creatorcontrib><creatorcontrib>Pratali, Raphael</creatorcontrib><creatorcontrib>Acácio, Ricardo</creatorcontrib><creatorcontrib>Romeiro, Carlos</creatorcontrib><creatorcontrib>Magno, Marcus Vinicius</creatorcontrib><creatorcontrib>Daher, Murilo</creatorcontrib><creatorcontrib>Herrero, Carlos Fernando P. S.</creatorcontrib><creatorcontrib>Brazilian Spine Study Group</creatorcontrib><title>Evaluation of the use of tranexamic acid in the postoperative period in patients with scoliosis undergoing posterior fusion</title><title>Neurosurgical review</title><addtitle>Neurosurg Rev</addtitle><addtitle>Neurosurg Rev</addtitle><description>Scoliosis is the most prevalent type of spinal deformity, with a 2–3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complications. Several antifibrinolytic drugs, such as tranexamic acid, have been regarded as safe and effective options for reducing blood loss. Therefore, the present study aimed to analyse the effectiveness of this drug for controlling bleeding when used intraoperatively and in the first 48 h after surgery. A prospective randomized study of a cohort of patients included in a mass event for scoliosis treatment using PSF was performed. Twenty-eight patients were analysed and divided into two groups: 14 patients were selected for intraoperative and postoperative use of tranexamic acid (TXA), and the other 14 were selected only during the intraoperative period. The drainage bleeding rate, length of hospital stay, number of transfused blood units, and rate of adverse clinical effects were compared. All the patients involved had similar numbers of fusion levels addressed and similar scoliosis profiles. The postoperative bleeding rate through the drain did not significantly differ between the two groups (
p
> 0.05). There was no significant difference in the number of transfused blood units between the groups (
p
= 0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically significant difference. Furthermore, the groups had similar adverse effects (
p
= 0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group. 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S.</au><aucorp>Brazilian Spine Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of the use of tranexamic acid in the postoperative period in patients with scoliosis undergoing posterior fusion</atitle><jtitle>Neurosurgical review</jtitle><stitle>Neurosurg Rev</stitle><addtitle>Neurosurg Rev</addtitle><date>2024-08-10</date><risdate>2024</risdate><volume>47</volume><issue>1</issue><spage>416</spage><pages>416-</pages><artnum>416</artnum><issn>1437-2320</issn><eissn>1437-2320</eissn><abstract>Scoliosis is the most prevalent type of spinal deformity, with a 2–3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complications. Several antifibrinolytic drugs, such as tranexamic acid, have been regarded as safe and effective options for reducing blood loss. Therefore, the present study aimed to analyse the effectiveness of this drug for controlling bleeding when used intraoperatively and in the first 48 h after surgery. A prospective randomized study of a cohort of patients included in a mass event for scoliosis treatment using PSF was performed. Twenty-eight patients were analysed and divided into two groups: 14 patients were selected for intraoperative and postoperative use of tranexamic acid (TXA), and the other 14 were selected only during the intraoperative period. The drainage bleeding rate, length of hospital stay, number of transfused blood units, and rate of adverse clinical effects were compared. All the patients involved had similar numbers of fusion levels addressed and similar scoliosis profiles. The postoperative bleeding rate through the drain did not significantly differ between the two groups (
p
> 0.05). There was no significant difference in the number of transfused blood units between the groups (
p
= 0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically significant difference. Furthermore, the groups had similar adverse effects (
p
= 0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group. No significant differences were found in the use of TXA during the first 48 postoperative hours or in postoperative outcomes.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39122900</pmid><doi>10.1007/s10143-024-02599-3</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Antifibrinolytic Agents - therapeutic use Blood Loss, Surgical - prevention & control Blood Transfusion - statistics & numerical data Female Humans Length of Stay Male Medicine Medicine & Public Health Neurosurgery Postoperative Hemorrhage - epidemiology Postoperative Period Prospective Studies Scoliosis - surgery Spinal Fusion - adverse effects Spinal Fusion - methods Tranexamic Acid - therapeutic use Treatment Outcome Young Adult |
| title | Evaluation of the use of tranexamic acid in the postoperative period in patients with scoliosis undergoing posterior fusion |
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