Tranexamic acid reduces blood cost in long-segment spinal fusion surgery: Retraction

Abstract

Objective: Long-segment spinal fusion surgery was associated with substantial perioperative blood loss which may increase hospitalization expenses and mortality rates. Substantial studies have reported that tranexamic acid (TXA) could reduce blood products and cost after joint arthroplasty surgery. However, there still exists controversy regarding the efficacy of TXA in long-segment spinal fusion surgery. We performed this protocol to design a randomized controlled study to evaluate the efficacy of TXA in decreasing transfusion rate of allogeneic blood products and transfusion cost in degenerative lumbar scoliosis patients. Methods: This study was carried out as a double-blinded, randomized clinical trial on patients with degenerative lumbar scoliosis who prepared for long-segment spinal fusion surgery from December 2018 to December 2019. It was authorized via the Institutional Review Committee in Southwest Medical University (ky2019225). Eighty patients were divided randomly into 2 groups (Experimental group = 40, control group = 40). The patients in the experimental group received 1000 mg of TXA mixed in 100 mL normal saline as a single dose intravenously over 20 minutes before the skin incision was made. Control group received equivalent normal saline without TXA. Primary outcomes included total blood loss, estimated intraoperative blood loss, hematocrit and hemoglobin decline, postoperative drain amount, intra-/postoperative allogeneic transfusion amount and rate, and total transfusion cost. Secondary outcomes included surgical time, thrombotic complications including deep vein thrombosis and pulmonary embolism. All the needed analyses were implemented through utilizing SPSS for Windows Version 20.0. Results: Table showed the relevant clinical outcomes between experimental group and control group. Conclusion: We hypothesized that TXA was effective and safe in reducing blood transfusion and cost in long-segment spinal fusion surgery. Trial registration: This study protocol was registered in Research Registry (researchregistry5854).

Tranexamic acid dosing strategies and blood loss reduction in multilevel spine surgery: A systematic review and network meta-analysis

“…[6] Adverse effects can be quite severe and include fever, infection, hemolytic reactions, and transfusion-related acute lung injury. [4,7] Optimal strategies to decrease blood loss throughout these spinal surgeries are still under investigation and include intraoperative blood salvage, hypotensive anesthesia, and intravenous (IV) hemostatic agents. [2] Tranexamic acid (TXA), an anti-fibrinolytic, has successfully been in use as a pharmacological intervention to decrease blood loss volume (BLV) throughout surgery when administered either through IV or topically.…”

“…These surgeries may lead to substantial intraoperative and postoperative blood loss both visible and hidden in dead space, [ 1 , 2 ] with research showing a significant association between the number of vertebral levels fused and volume of blood lost. [3] Perioperative blood loss in long-segment spinal surgery has been shown to increase hospital stays, procedure costs, and mortality rates [4] ; this is partly due to the need for postoperative blood transfusions, with a reported need in as high as 50-80% of patients. [5] A blood transfusion is not a benign treatment and can have an 8- to 10-fold excess risk of adverse outcomes when administered.…”

“… [6] Adverse effects can be quite severe and include fever, infection, hemolytic reactions, and transfusion-related acute lung injury. [ 4 , 7 ]…”

Tranexamic acid reduces blood cost in long-segment spinal fusion surgery: a randomized controlled study protocol: Retraction

“…The article, “Tranexamic acid reduces blood cost in long-segment spinal fusion surgery: A randomized controlled study protocol”, [1] which appeared in Volume 99, Issue 37 of Medicine is being retracted. This article was initially published with an incomplete table provided by the authors, and an erratum published in anticipation of the corrected version.…”

Tranexamic acid reduces blood cost in long-segment spinal fusion surgery: A randomized controlled study protocol: Partial Retraction

“…In the article, “Tranexamic acid reduces blood cost in long-segment spinal fusion surgery: A randomized controlled study protocol”, [ 1 ] which appears in Volume 99, Issue 37 of Medicine , Table 1 was not provided and the article inadvertently published missing this content. The author has not responded to multiple attempts to secure the missing table, therefore it is being retracted from the article.…”