The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis
Abstract Background There is controversy regarding the efficacy of intravenous combined topical tranexamic acid. We conducted this study to systematically assess the effectiveness of intravenous combined topical tranexamic acid (combined TXA) in spinal surgery to guide clinical practice. Methods The...
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BMC
2024-12-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08191-6 |
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| author | Chengxin Xie Yu Ren Xiaoxiao Chen Yanwu Zhu Jiao Jiang Bing Lu Hua Luo |
| author_facet | Chengxin Xie Yu Ren Xiaoxiao Chen Yanwu Zhu Jiao Jiang Bing Lu Hua Luo |
| author_sort | Chengxin Xie |
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| description | Abstract Background There is controversy regarding the efficacy of intravenous combined topical tranexamic acid. We conducted this study to systematically assess the effectiveness of intravenous combined topical tranexamic acid (combined TXA) in spinal surgery to guide clinical practice. Methods The review process was conducted according to the PRISMA guidelines. A systematic search of PubMed, EMBASE, Web of Science, and Cochrane Central was conducted for RCTs and comparative cohort studies evaluating the effect of combined TXA on blood loss in spinal surgery. Outcomes such as intraoperative blood loss, total blood loss, postoperative drainage, postoperative hemoglobin level on postoperative days 1 and 3, postoperative transfusion rates, and complications were analyzed. Results Five studies covering 528 patients were included in the analysis. Combined TXA, compared with intravenous TXA, showed no significant differences in intraoperative blood loss (P = 0.18 for RCTs, P = 0.50 for the retrospective study), total blood loss (P = 0.085 for RCTs, P = 0.87 for the retrospective study), postoperative drainage (P = 0.137 for RCTs, P = 0.232 for the retrospective study), postoperative hemoglobin (P = 0.737 on postoperative day 1, P = 0.403 on postoperative day 3), postoperative transfusion rates (P = 0.202), and complications (P = 0.493). Conclusions Based on the available evidences, our meta-analysis failed to demonstrate the apparent advantages of combined tranexamic acid in spinal surgery. Clinical decisions regarding hemostatic methods should continue to be individualized based on the patient's specific situation and the doctor's experience. |
| format | Article |
| id | doaj-art-035287eead854130a3a201e8f3f57f0c |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-035287eead854130a3a201e8f3f57f0c2024-12-29T12:07:54ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-0125111010.1186/s12891-024-08191-6The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysisChengxin Xie0Yu Ren1Xiaoxiao Chen2Yanwu Zhu3Jiao Jiang4Bing Lu5Hua Luo6Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Operation Room, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityAbstract Background There is controversy regarding the efficacy of intravenous combined topical tranexamic acid. We conducted this study to systematically assess the effectiveness of intravenous combined topical tranexamic acid (combined TXA) in spinal surgery to guide clinical practice. Methods The review process was conducted according to the PRISMA guidelines. A systematic search of PubMed, EMBASE, Web of Science, and Cochrane Central was conducted for RCTs and comparative cohort studies evaluating the effect of combined TXA on blood loss in spinal surgery. Outcomes such as intraoperative blood loss, total blood loss, postoperative drainage, postoperative hemoglobin level on postoperative days 1 and 3, postoperative transfusion rates, and complications were analyzed. Results Five studies covering 528 patients were included in the analysis. Combined TXA, compared with intravenous TXA, showed no significant differences in intraoperative blood loss (P = 0.18 for RCTs, P = 0.50 for the retrospective study), total blood loss (P = 0.085 for RCTs, P = 0.87 for the retrospective study), postoperative drainage (P = 0.137 for RCTs, P = 0.232 for the retrospective study), postoperative hemoglobin (P = 0.737 on postoperative day 1, P = 0.403 on postoperative day 3), postoperative transfusion rates (P = 0.202), and complications (P = 0.493). Conclusions Based on the available evidences, our meta-analysis failed to demonstrate the apparent advantages of combined tranexamic acid in spinal surgery. Clinical decisions regarding hemostatic methods should continue to be individualized based on the patient's specific situation and the doctor's experience.https://doi.org/10.1186/s12891-024-08191-6Tranexamic acidSpinal surgeryBlood lossComplication |
| spellingShingle | Chengxin Xie Yu Ren Xiaoxiao Chen Yanwu Zhu Jiao Jiang Bing Lu Hua Luo The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis BMC Musculoskeletal Disorders Tranexamic acid Spinal surgery Blood loss Complication |
| title | The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis |
| title_full | The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis |
| title_fullStr | The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis |
| title_full_unstemmed | The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis |
| title_short | The efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery: a systematic review and meta-analysis |
| title_sort | efficacy and safety of topical combined with intravenous administration of tranexamic acid in spine surgery a systematic review and meta analysis |
| topic | Tranexamic acid Spinal surgery Blood loss Complication |
| url | https://doi.org/10.1186/s12891-024-08191-6 |
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