Takuma Maeda1,2, Nobuaki Michihata3, Yusuke Sasabuchi4, Hiroki Matsui5, Yoshihiko Ohnishi1, Shigeki Miyata2, Hideo Yasunaga5. 1. Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan. 2. Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. 3. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 4. Data Science Center, Jichi Medical University, Shimotsuke, Tochigi, Japan. 5. Department of Clinical Epidemiology and Health Economics School of Public Health, The University of Tokyo, Tokyo, Japan.
Abstract
OBJECTIVES: The present study aimed to examine the association between tranexamic acid use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric trauma population using a national inpatient database in Japan. We also assessed the association between tranexamic acid use and in-hospital mortality. DESIGN: A nationwide, retrospective cohort study using propensity score analyses. SETTING: Japanese Diagnosis Procedure Combination inpatient database. PATIENTS: Pediatric patients less than or equal to 12 years old admitted in hospital with the diagnosis of trauma between July 2010 and March 2014 (n = 61,779). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Propensity score matching created 1,914 pairs of patients with and without tranexamic acid administration. Propensity-matched analysis showed that the proportion of seizures was significantly higher in the tranexamic acid group than in the nontranexamic acid group (7/1,914, 0.37% vs 0/1,914, 0%; difference, 0.37%; 95% CI, 0.10-0.64; p = 0.008). However, none of the other outcomes were significantly different between the groups. CONCLUSIONS: Tranexamic acid use is associated with a significantly increased risk of seizures. However, no difference exists among any other outcomes between the tranexamic acid and nontranexamic acid groups.
OBJECTIVES: The present study aimed to examine the association between tranexamic acid use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric trauma population using a national inpatient database in Japan. We also assessed the association between tranexamic acid use and in-hospital mortality. DESIGN: A nationwide, retrospective cohort study using propensity score analyses. SETTING: Japanese Diagnosis Procedure Combination inpatient database. PATIENTS: Pediatric patients less than or equal to 12 years old admitted in hospital with the diagnosis of trauma between July 2010 and March 2014 (n = 61,779). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Propensity score matching created 1,914 pairs of patients with and without tranexamic acid administration. Propensity-matched analysis showed that the proportion of seizures was significantly higher in the tranexamic acid group than in the nontranexamic acid group (7/1,914, 0.37% vs 0/1,914, 0%; difference, 0.37%; 95% CI, 0.10-0.64; p = 0.008). However, none of the other outcomes were significantly different between the groups. CONCLUSIONS:Tranexamic acid use is associated with a significantly increased risk of seizures. However, no difference exists among any other outcomes between the tranexamic acid and nontranexamic acid groups.
Authors: Devon B O'Donnell; Sima Vazquez; Jacob D Greisman; Anaz Uddin; Gillian Graifman; Jose F Dominguez; Elizabeth Zellner; Carrie R Muh Journal: Plast Reconstr Surg Glob Open Date: 2022-10-17