Postoperative Low-Dose Tranexamic Acid After Major Spine Surgery: A Matched Cohort Analysis

التفاصيل البيبلوغرافية
العنوان:	Postoperative Low-Dose Tranexamic Acid After Major Spine Surgery: A Matched Cohort Analysis
المؤلفون:	Lauren K. Dunn, Ching-Jen Chen, Davis G. Taylor, Kamilla Esfahani, Brian Brenner, Charles Luo, Thomas J. Buell, Sarah N. Spangler, Avery L. Buchholz, Justin S. Smith, Christopher I. Shaffrey, Edward C. Nemergut, Marcel E. Durieux, Bhiken I. Naik
المصدر:	Neurospine, Vol 17, Iss 4, Pp 888-895 (2020)
بيانات النشر:	Korean Spinal Neurosurgery Society, 2020.
سنة النشر:	2020
المجموعة:	LCC:Neurology. Diseases of the nervous system
مصطلحات موضوعية:	tranexamic acid, fibrinolysis, antifibrinolytic agents, blood loss, Neurology. Diseases of the nervous system, RC346-429
الوصف:	Objective This was a retrospective, cohort study investigating the efficacy and safety of continuous low-dose postoperative tranexamic acid (PTXA) on drain output and transfusion requirements following adult spinal deformity surgery. Methods One hundred forty-seven patients undergoing posterior instrumented thoracolumbar fusion of ≥ 3 vertebral levels at a single institution who received low-dose PTXA infusion (0.5–1 mg/kg/hr) for 24 hours were compared to 292 control patients who did not receive PTXA. The cohorts were propensity matched based on age, sex, American Society of Anesthesiologist physical status classification, body mass index, number of surgical levels, revision surgery, operative duration, and total intraoperative TXA dose (n = 106 in each group). Primary outcome was 72-hour postoperative drain output. Secondary outcomes were number of allogeneic blood transfusions. Results There was no significant difference in postoperative drain output in the PTXA group compared to control (660 ±420 mL vs. 710 ±490 mL, p = 0.46). The PTXA group received significantly more crystalloid (6,100 ±3,100 mL vs. 4,600 ±2,400 mL, p < 0.001) and red blood cell transfusions postoperatively (median [interquartile range]: 1 [0–2] units vs. 0 [0–1] units; incidence rate ratio [95% confidence interval], 1.6 [1.2–2.2]; p = 0.001). Rates of adverse events were comparable between groups. Conclusion Continuous low-dose PTXA infusion was not associated with reduced drain output after spinal deformity surgery. No difference in thromboembolic incidence was observed. A prospective dose escalation study is warranted to investigate the efficacy of higher dose PTXA.
نوع الوثيقة:	article
وصف الملف:	electronic resource
اللغة:	English
تدمد:	2586-6583 2586-6591
Relation:	http://www.e-neurospine.org/upload/pdf/ns-2040114-057.pdf; https://doaj.org/toc/2586-6583; https://doaj.org/toc/2586-6591
DOI:	10.14245/ns.2040114.057
URL الوصول:	https://doaj.org/article/676e4be859ef4f7f98ce0200ee81030c
رقم الانضمام:	edsdoj.676e4be859ef4f7f98ce0200ee81030c
قاعدة البيانات:	Directory of Open Access Journals

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الوصف
تدمد:	25866583 25866591
DOI:	10.14245/ns.2040114.057