The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial

作者全名：Dong, Wei; Tang, Yuchen; Lei, Miao; Ma, Zhaoxin; Zhang, Xiaojun; Shen, Jieliang; Hao, Jie; Jiang, Wei; Hu, Zhenming

作者地址：[Dong, Wei; Tang, Yuchen; Lei, Miao; Ma, Zhaoxin; Zhang, Xiaojun; Shen, Jieliang; Hao, Jie; Jiang, Wei; Hu, Zhenming] Chongqing Med Univ, Orthoped Lab, Dept Orthoped, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Hu, Zhenming] Chongqing Med Univ, Univ Town Hosp, Dept Orthoped Surg, Chongqing 401331, Peoples R China

通信作者：Hao, J; Jiang, W; Hu, ZM (通讯作者)，Chongqing Med Univ, Orthoped Lab, Dept Orthoped, Affiliated Hosp 1, Chongqing 400016, Peoples R China.; Hu, ZM (通讯作者)，Chongqing Med Univ, Univ Town Hosp, Dept Orthoped Surg, Chongqing 401331, Peoples R China.

来源：INTERNATIONAL JOURNAL OF SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001203304700046

JCR分区：Q1

影响因子：12.5

年份：2024

卷号：110

期号：4

开始页：2122

结束页：2133

文献类型：Article

关键词：hyperfibrinolysis; posterior lumbar interbody fusion; postoperative blood loss; prediction model; tranexamic acid

摘要：Objective: The purpose of this retrospective cohort study was to evaluate the effect of tranexamic acid (TXA) on reducing perioperative blood loss and length of stay after transforaminal lumbar interbody fusion (TLIF). Spine surgery is associated with the potential for significant blood loss, and adequate hemostasis is essential to visualizing crucial structures during the approach and procedure. Although TXA use has been extensively studied in the pediatric and adult spinal deformity literature, there is a dearth of literature on its efficacy in reducing blood loss for patients who undergo 1- to 3-level TLIF. Methods: All patients requiring 1- to 3-level TLIF who received a preoperative loading dose of TXA were grouped and compared with patients who didn't receive TXA. Demographic, surgical, and laboratory values were collected and analyzed. Continuous and categorical variables were analyzed with chi(2), Kruskal-Wallis, or analysis of variance tests, depending on normality and data type. Multiple linear regressions were developed to determine independent predictors of the estimated blood loss (EBL), total blood loss, drain output, and length of stay. Statistical significance was set at P < 0.05. Results: Patients who received preoperative TXA had more comorbidities (P = 0.006), longer surgery length (P < 0.001), and longer length of stay (P = 0.004). TXA was independently associated with a decreased day 0, 1, 2, and total drain output (P < 0.001, P = 0.001, P = 0.007, P < 0.001, respectively), but was not associated with a change in EBL, total blood loss, or length of stay. Conclusions: The application of preoperative TXA for patients undergoing 1- to 3-level TLIF reduced drain output in the first 2 postoperative days, but it did not affect hospital length of stay, total blood loss, or EBL.

基金机构：College of Public Health of Chongqing Medical University

基金资助正文：Thank Professor Mengliang Ye of the College of Public Health of Chongqing Medical University for the guidance of statistics in this study.