Abstract | BACKGROUND CONTEXT: PURPOSE: To consolidate the findings of randomized controlled trials (RCTs) investigating the use of TXA on surgical bleeding in spine surgery. STUDY DESIGN: A metaanalysis. STUDY SAMPLE: Randomized controlled trials investigating the effectiveness of intravenous TXA in reducing blood loss in spine surgery, compared with a placebo/no treatment group. METHODS: MEDLINE, Embase, Cochrane controlled trials register, and Google Scholar were used to identify RCTs published before January 2014 that examined the effectiveness of intravenous TXA on reduction of blood loss and blood transfusions, compared with a placebo/no treatment group in spine surgery. Metaanalysis was performed using RevMan 5. Weighted mean difference with 95% confidence intervals was used to summarize the findings across the trials for continuous outcomes. Dichotomous data were expressed as risk ratios with 95% confidence intervals. A p<.05 was considered statistically significant. RESULTS: Eleven RCTs were included for TXA (644 total patients). Tranexamic acid reduced intraoperative, postoperative, and total blood loss by an average of 219 mL ([-322, -116], p<.05), 119 mL ([-141, -98], p<.05), and 202 mL ([-299, -105], p<.05), respectively. Tranexamic acid led to a reduction in proportion of patients who received a blood transfusion (risk ratio 0.67 [0.54, 0.83], p<.05) relative to placebo. There was one myocardial infarction (MI) in the TXA group and one deep vein thrombosis (DVT) in placebo. CONCLUSIONS:
|
Authors | Thomas Cheriyan, Stephen P Maier 2nd, Kristina Bianco, Kseniya Slobodyanyuk, Rachel N Rattenni, Virginie Lafage, Frank J Schwab, Baron S Lonner, Thomas J Errico |
Journal | The spine journal : official journal of the North American Spine Society
(Spine J)
Vol. 15
Issue 4
Pg. 752-61
(Apr 01 2015)
ISSN: 1878-1632 [Electronic] United States |
PMID | 25617507
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Chemical References |
- Antifibrinolytic Agents
- Tranexamic Acid
|
Topics |
- Antifibrinolytic Agents
(therapeutic use)
- Blood Loss, Surgical
(prevention & control)
- Humans
- Orthopedic Procedures
(adverse effects)
- Spine
(surgery)
- Tranexamic Acid
(therapeutic use)
- Treatment Outcome
|