The Frequency of Thrombotic Events Among Adults Given Antifibrinolytic Drugs for Spontaneous Bleeding: Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials

Ross, Jenny; Salman, Rustam Al-Shahi

doi:10.2174/157488612800492744

Cited by 41 publications

(27 citation statements)

References 17 publications

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“…Some investigators have suggested that TXA activates fibrinolysis but does not affect coagulation. Therefore, the use of TXA seldom leads to thrombosis (27,28). In the present study, we screened for postoperative thromboembolic events for a minimum of 12 weeks after the surgery; however, no statistically significant differences in the clinical symptoms or signs of thrombosis were found between the 2 groups.…”

Section: Discussionmentioning

confidence: 78%

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

Xie

Tian

Zhou

2015

The Journal of Foot and Ankle Surgery

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Section: Discussionmentioning

confidence: 78%

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

Xie

Tian

Zhou

2015

The Journal of Foot and Ankle Surgery

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“…However, the effect of TAX on thromboembolic events and mortality remains unclear. Ross et al conducted a systematic review on the association of frequency of thrombotic events with TAX after spontaneous bleeding, finding the frequency of some events, such as DVT, decreased with TXA treatment [30], lower rate of several complication, such as DVT, pulmonary embolism (PE), and arterioocclusive events was observed when TXA was applied as a blood conservation modality during primary total hip and knee arthroplasty [31]. Although TXA has demonstrated to be effective in in mediating DVT in many types of surgery, the efficacy and safety of TXA in spinal surgery remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Perioperative Intravenous Tranexamic Acid Use in Spinal Surgery

et al. 2013

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BackgroundTranexamic acid (TXA) is well-established as a versatile oral, intramuscular, and intravenous (IV) antifibrinolytic agent. However, the efficacy of IV TXA in reducing perioperative blood transfusion in spinal surgery is poorly documented.MethodologyWe conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-randomized (qi-RCTs) trials that included patients for various spinal surgeries, such as adolescent scoliosis surgery administered with perioperative IV TXA according to Cochrane Collaboration guidelines using electronic PubMed, Cochrane Central Register of Controlled Trials, and Embase databases. Additional journal articles and conference proceedings were manually located by two independent researchers.ResultsTotally, nine studies were included, with a total sample size of 581 patients. Mean blood loss was decreased in patients treated with perioperative IV TXA by 128.28 ml intraoperatively (ranging from 33.84 to 222.73 ml), 98.49 ml postoperatively (ranging from 83.22 to 113.77 ml), and 389.21 ml combined (ranging from 177.83 to 600.60 ml). The mean volume of transfused packed cells were reduced by 134.55 ml (ranging 51.64 to 217.46) (95% CI; P = 0.0001). Overall, the number of patients treated with TXA who required blood transfusions was lower by 35% than that of patients treated with the comparator and who required blood transfusions (RR 0.65; 95% CI; 0.53 to 0.85; P<0.0001, I2 = 0%). A dose-independent beneficial effect of TXA was observed, and confirmed in subgroup and sensitivity analyses. A total of seven studies reported DVT data. The study containing only a single DVT case was not combined.ConclusionsThe blood loss was reduced in spinal surgery patients with perioperative IV TXA treatment. Also the percentage of spinal surgery patients who required blood transfusion was significantly decreased. Further evaluation is required to confirm our findings before TXA can be safely used in patients undergoing spine surgery.

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“…1 , 2 Furthermore, the increased length of blood loss-associated intensive care unit stay results in signifi cantly higher health care costs. [6][7][8][9][10][11] As previously mentioned, TXA and EACA have a welldocumented role in several types of surgery. Although aprotinin has been removed from the market, TXA and EACA have become widely used in several types of surgery, including cardiac and orthopedic.…”

mentioning

confidence: 91%

Antifibrinolytics Reduce Blood Loss in Adult Spinal Deformity Surgery

Peters

Verma

Slobodyanyuk

et al. 2015

Spine

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The Frequency of Thrombotic Events Among Adults Given Antifibrinolytic Drugs for Spontaneous Bleeding: Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials

Abstract: Thrombotic events have occurred infrequently with antifibrinolytic drugs after spontaneous bleeding apart from subarachnoid haemorrhage, so further exploration of their safety and efficacy after spontaneous bleeding is justified in randomized trials.

Cited by 41 publications

References 17 publications

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

Systematic Review and Meta-Analysis of Perioperative Intravenous Tranexamic Acid Use in Spinal Surgery

Antifibrinolytics Reduce Blood Loss in Adult Spinal Deformity Surgery

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