Prophylactic Topical Tranexamic Acid versus Placebo in Surgical Patients: A Systematic Review and Meta-Analysis
Introduction: Tranexamic acid (TxA) is used in surgery to reduce blood loss. However, its safety profile is unclear. This review examined the efficacy and safety profile of topical TxA. Method: Electronic databases including Medline and EMBASE were searched from inception to May 2019. Randomised...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | en |
| Published: |
BJS
2020
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/36636/1/prophylactic2.pdf http://ir.unimas.my/id/eprint/36636/ https://bjssjournals.onlinelibrary.wiley.com/journal/13652168 |
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| Summary: | Introduction: Tranexamic acid (TxA) is used in surgery to reduce blood loss.
However, its safety profile is unclear. This review examined the efficacy and
safety profile of topical TxA.
Method: Electronic databases including Medline and EMBASE were searched
from inception to May 2019. Randomised controlled trials (RCTs) published in
English comparing topical TxA with placebo were included. Primary outcomes
were mortality and blood transfusion incidence. Secondary outcomes included
venous thromboembolism.
Result: 7,539 patients from 71 RCTs were analysed. Compared to placebo,
topical TxA reduced blood transfusion incidence (OR 0.30, 95%CI [0.26 - 0.34],
p<0.001). Topical TxA use had no impact on mortality (OR 0.78, 95%CI [0.45 -
1.36], p = 0.39). Pulmonary embolism (OR 0.73, 95%CI 0.27 to 1.93, p = 0.52)
and deep vein thrombosis (OR 0.79, 95%CI [0.65 to 1.77], p = 0.79) were not
associated with topical TxA use.
Conclusion: Topical TxA is effective in reducing transfusion need in surgery
without association to major adverse events. However, its optimal dosing regime
remain to be determined. |
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