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Tranexamic acid dosage for spinal surgery: a meta-analysis

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Abstract

Purpose

We conducted this meta-analysis of randomized controlled trials (RCTs) to compare the efficacy of different doses of intravenous tranexamic acid (TXA) in spinal surgery.

Methods

We searched relevant academic articles from PubMed, Embase, the Cochrane Library, and CNKI. Two reviewers independently selected studies, assessed quality, extracted data, and evaluated the risk of bias. RevMan 5.4 was used for data analysis.

Results

Ten randomized controlled trials (RCTs) met the inclusion criteria and were identified, including 740 patients. According to the different dose regimens of intravenous TXA, the included studies’ patients were divided into the high dose of intravenous TXA group and the low dose of intravenous TXA group. Compared with the low-dose group, the high-dose group can reduce the intraoperative blood loss (MD = − 100.87, 95% CI: [− 147.81, − 53.92], P < 0.0001). For the postoperative Hb and HCT, the high-dose group can separately maintain 4.54 g/dL (MD = 4.54, 95% CI: [2.08, 6.99], P = 0.003) and 1.27% (MD = 1.27, 95% CI: [0.59, 1.94], P = 0.0002). There were no statistically significant differences in total blood loss, preoperative Hb and HCT, operative time, and blood transfusion rate between the high-dose group and the low-dose group.

Conclusions

Based on the present meta-analysis, compared with the low-dose of intravenous TXA in spinal surgery, the high dose of intravenous TXA decreases the intraoperative blood loss and preserves higher postoperative Hb and HCT levels without increasing the operative time and blood transfusion rate.

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Availability of data and material

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

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Funding

This work was supported by the following funding: The Joint Project of Yunnan Science and Technology Department and Kunming Medical University Foundation (Grant Number 202201AY070001-054).

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Authors and Affiliations

  1. Department of Orthopedics, The First Affiliated Hospital, Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan, China

    Chao Qin, Kai-li Du, Pei-yu Guo, Hong-da Gong & Chun-qiang Zhang

Authors
  1. Chao Qin
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  2. Kai-li Du
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  3. Pei-yu Guo
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  4. Hong-da Gong
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  5. Chun-qiang Zhang
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Contributions

All authors contributed to the study conception and design. Database searching, material preparation, data collection and analysis were performed by CQ, PG, HG, KD. The first draft of the manuscript was written by CQ and KD, and the final draft was modified by CZ and KD. CQ and KD contributed equally to this paper. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chun-qiang Zhang.

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The authors have no relevant financial or non-financial interests to disclose.

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Drs. Chao Qin and Kaili Du contributed equally to this paper. And all the authors have given their consent to this choice. There won't be any overlapping interests.

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Qin, C., Du, Kl., Guo, Py. et al. Tranexamic acid dosage for spinal surgery: a meta-analysis. Eur Spine J 31, 2493–2501 (2022). https://doi.org/10.1007/s00586-022-07315-7

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  • DOI: https://doi.org/10.1007/s00586-022-07315-7

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