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Efficacy and safety of tranexamic acid usage in patients undergoing posterior lumbar fusion: a meta-analysis.
Bai, Jianzhong; Zhang, Pei; Liang, Yuan; Wang, Jingcheng; Wang, Yongxiang.
Afiliação
  • Bai J; Department of Orthopedics, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital, Nantong West Road 98, Yangzhou, 225001, China.
  • Zhang P; Dalian Medical University, Dalian, 116044, Liaoning, China.
  • Liang Y; Department of Orthopedics, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital, Nantong West Road 98, Yangzhou, 225001, China.
  • Wang J; Department of Orthopedics, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital, Nantong West Road 98, Yangzhou, 225001, China.
  • Wang Y; Department of Orthopedics, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital, Nantong West Road 98, Yangzhou, 225001, China. wangjcyangzhou@163.com.
BMC Musculoskelet Disord ; 20(1): 390, 2019 Aug 31.
Article em En | MEDLINE | ID: mdl-31470844
BACKGROUND: The purpose of this meta-analysis is to evaluate the efficacy and safety of tranexamic acid (TXA) for patients with degenerative lumbar disc herniation, stenosis or instability undergoing posterior lumbar fusion (PLF) surgery. METHODS: We searched PubMed, Embase, and Cochrane Library until May 1, 2018. Two reviewers selected studies, assessed quality, extracted data, and evaluated the risk of bias independently. Weighted mean difference (WMD) and relative risk (RR) were calculated as the summary statistics for continuous data and dichotomous data, respectively. We chose fixed-effects or random-effects models based on I2 statistics. RevMan 5.0 and STATA 14.0 software were used for data analysis. RESULTS: Nine studies enrolling 713 patients for the study. The pooled outcomes demonstrated that TXA can decrease total blood loss (TBL) in patients underwent PLF surgery [WMD = -250.68, 95% CI (- 325.06, - 176.29), P<0.001], intraoperative blood loss (IBL) [WMD = -72.57, 95% CI (- 103.94, - 41.20), P<0.001], postoperative blood loss (PBL) [WMD = -127.57, 95% CI (- 149.39, - 105.75), P<0.001], and the loss of hemoglobin (Hb) in postoperative 24 h [WMD = -0.31, 95% CI (- 0.44, - 0.18), P<0.001]. However, there is no significant difference between two groups in transfusion rate [RR =0.34, 95% CI (0.09, 1.28), P = 0.11], and none thrombotic event was happened in the two groups. CONCLUSION: Our meta-analysis demonstrated that TXA can decrease the Hb loss, TBL, IBL, PBL, and without increasing the risk of thrombotic event in patients with degenerative lumbar disc herniation, stenosis or instability underwent PLF surgery. However, there was no significant difference in blood transfusion rates between the two groups.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fusão Vertebral / Ácido Tranexâmico / Perda Sanguínea Cirúrgica / Hemorragia Pós-Operatória / Antifibrinolíticos Tipo de estudo: Etiology_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fusão Vertebral / Ácido Tranexâmico / Perda Sanguínea Cirúrgica / Hemorragia Pós-Operatória / Antifibrinolíticos Tipo de estudo: Etiology_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: China