A meta-analysis of the effectiveness and safety of using tranexamic acid in spine surgery / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To assess the effectiveness and safety of using tranexamic acid (TXA) in reducing blood loss in spine surgery through a meta-analysis.</p><p><b>METHODS</b>Literatures before November 2009 were identified from the PubMed, EMBase, Cochrane library, CNKI and VIP databases. Relevant journals or conference proceedings were also searched manually. This study only enrolled high quality (Jadad scores ≥ 3) randomized controlled trials (RCTs). Two independent reviewers searched and assessed the literatures.Weighted mean difference (WMD) of blood loss and blood transfusions, odds ratio (OR) of transfusion rate and of deep vein thrombosis (DVT) rate in TXA-treated group versus placebo group were calculated across the studies. The statistical analysis were conducted by the software of RevMan 4.2.</p><p><b>RESULTS</b>Four double-blinded RCTs met the inclusion criteria for meta-analysis. The total sample size of these studies was 295. The use of TXA significantly reduced total blood loss [WMD = -523.74, 95%CI (-778.92, -268.56), P < 0.01], blood volumes of transfusion [WMD = -242.28, 95%CI (-394.02, -90.54), P = 0.002] and proportion of patients requiring blood transfusion [OR = 0.57, 95%CI (0.34, 0.93), P = 0.020], while did not raise the risk of DVT, as compared with placebo group.</p><p><b>CONCLUSIONS</b>This meta-analysis indicates that the use of TXA infusion for patients undergoing spine surgery is effective in reducing total blood loss, transfusion volumes and the rate of transfusion, yet doesn't raise the risk of postoperative DVT.</p>