Loading...
Please wait, while we are loading the content...
Similar Documents
Effect of Intraoperative Tranexamic Acid on Perioperative Major Hemorrhage Requiring Transfusion in Patients Undergoing Elective Spine Surgery: A Propensity Score-Matched Analysis Using a National Inpatient Database
| Content Provider | SAGE Publishing |
|---|---|
| Author | Honda, Akira Iizuka, Yoichi Michihata, Nobuaki Uda, Kazuaki Mieda, Tokue Takasawa, Eiji Ishiwata, Sho Kakuta, Yohei Tomomatsu, Yusuke Ito, Shunsuke Inomata, Kazuhiro Matsui, Hiroki Fushimi, Kiyohide Yasunaga, Hideo Chikuda, Hirotaka |
| Copyright Year | 2022 |
| Abstract | Study DesignRetrospective cohort study.ObjectivesThis study aimed to examine whether the use of intravenous TXA in elective spine surgery is associated with reduced perioperative massive hemorrhage requiring transfusion.MethodsWe extracted all patients who underwent decompression with or without fusion surgery for the cervical, thoracic, and lumbar spine between April 2012 and March 2019. The primary outcome was the occurrence of massive hemorrhage requiring transfusion, defined as at least 560 mL of blood transfusion within 2 days of spine surgery or the requirement of additional blood transfusion from 3-7 days postoperatively. Secondary outcomes were the occurrence of thrombotic complications (pulmonary embolism, acute coronary syndrome, and stroke) and postoperative hematoma requiring additional surgery.ResultsWe identified 83,821 eligible patients, with 9747 (12%) patients in the TXA group. Overall, massive hemorrhage requiring transfusion occurred in 781 (.9%) patients. Propensity score matching yielded 8394 pairs. In the matched cohort, the TXA group had a lower proportion of massive hemorrhage requiring transfusion than the control group (.7% vs 1.1%; P = .002). There was no significant difference in the occurrence of thrombotic complications and postoperative hematoma requiring additional surgery between both groups. The multivariable regression analysis also showed that the use of TXA was associated with significantly lower proportions of massive hemorrhage requiring transfusion (odds ratio, .62; 95% confidence interval, .43-.90; P = .012).ConclusionsIn this analysis using real-world data, TXA use in elective spinal surgery was associated with reduced perioperative massive hemorrhage requiring transfusion without increasing thrombotic complications.Level of evidencePrognostic Level Ⅲ |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/21925682221123317?download=true |
| ISSN | 21925682 |
| Journal | Global Spine Journal (GSJ) |
| e-ISSN | 21925690 |
| DOI | 10.1177/21925682221123317 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2022-08-25 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2022 |
| Subject Keyword | tranexamic acid major hemorrhage requiring transfusion elective spine surgery thrombotic complications nationwide inpatient database |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Neurology (clinical) Surgery |
