BACKGROUND: Tranexamic acid is a synthetic lysine-analogue antifibrinolytic that competitively inhibits the activation of plasminogen to plasmin, it is a well-documented blood sparing agent. However, its routine use in idiopathic scoliosis surgery is poorly documented. The objective of this meta-analysis was to determine TXA's efficacy in reducing blood loss and blood transfusion in idiopathic scoliosis surgery. METHODS: Five databases (Medline, PubMed, Web of Science, Embase and The Cochrane Central Register of Controlled Trials) were searched to identify the relevant randomized controlled trials (RCTs), prospective cohort control (PCC), and retrospective controlled trails regarding the TXA efficacy in idiopathic scoliosis surgery. Mean differences (MDs) of blood loss and blood transfusions in TXA-treated group compared to control and/or placebo group were extracted and combined using random-effect meta-analysis model. RESULTS: A total of seven studies comprising 426 patients were included in the meta-analysis according to the pre-defined selection criteria. TXA-treated group had an overall significantly (P<0.005) less volume of blood loss [ES (MD) =727.71 mL; CI, 281.86-1,173.56 mL]. Six studies comprising 346 patients TXA-treated group had an overall significantly {P<0.001 less transfusion volume [ES (MD) =268.30 mL; CI, 105.19-431.44 mL]}. CONCLUSIONS: Patients treated with TXA had a significantly lower blood loss and lower rates of allogeneic blood transfusion than the control group. Further investigation is required regarding the safety of TXA before it can be generalized in the use of idiopathic scoliosis surgery.
BACKGROUND: Tranexamic acid is a synthetic lysine-analogue antifibrinolytic that competitively inhibits the activation of plasminogen to plasmin, it is a well-documented blood sparing agent. However, its routine use in idiopathic scoliosis surgery is poorly documented. The objective of this meta-analysis was to determine TXA's efficacy in reducing blood loss and blood transfusion in idiopathic scoliosis surgery. METHODS: Five databases (Medline, PubMed, Web of Science, Embase and The Cochrane Central Register of Controlled Trials) were searched to identify the relevant randomized controlled trials (RCTs), prospective cohort control (PCC), and retrospective controlled trails regarding the TXA efficacy in idiopathic scoliosis surgery. Mean differences (MDs) of blood loss and blood transfusions in TXA-treated group compared to control and/or placebo group were extracted and combined using random-effect meta-analysis model. RESULTS: A total of seven studies comprising 426 patients were included in the meta-analysis according to the pre-defined selection criteria. TXA-treated group had an overall significantly (P<0.005) less volume of blood loss [ES (MD) =727.71 mL; CI, 281.86-1,173.56 mL]. Six studies comprising 346 patients TXA-treated group had an overall significantly {P<0.001 less transfusion volume [ES (MD) =268.30 mL; CI, 105.19-431.44 mL]}. CONCLUSIONS: Patients treated with TXA had a significantly lower blood loss and lower rates of allogeneic blood transfusion than the control group. Further investigation is required regarding the safety of TXA before it can be generalized in the use of idiopathic scoliosis surgery.
Authors: Daniel J Johnson; Christine C Johnson; Susan M Goobie; Nina Nami; Joshua A Wetzler; Paul D Sponseller; Steven M Frank Journal: J Pediatr Orthop Date: 2017-12 Impact factor: 2.324
Authors: John A Grant; Jason Howard; Jeremy Luntley; James Harder; Sami Aleissa; David Parsons Journal: J Pediatr Orthop Date: 2009 Apr-May Impact factor: 2.324
Authors: Dhwani Hariharan; Marco Mammi; Kelicia Daniels; Nayan Lamba; Kerilyn Petrucci; Christian D Cerecedo-Lopez; Joanne Doucette; Alexander F C Hulsbergen; Stefania Papatheodorou; Linda S Aglio; Timothy R Smith; Rania A Mekary; Hasan Zaidi Journal: Drugs Date: 2019-10 Impact factor: 9.546