التفاصيل البيبلوغرافية
| العنوان: |
Tranexamic acid use to decrease blood loss in primary shoulder and elbow replacement: A systematic review and meta-analysis. |
| المؤلفون: |
Donovan, Richard L., Varma, Jonny R., Whitehouse, Michael R., Blom, Ashley W., Kunutsor, Setor K. |
| المصدر: |
Journal of Orthopaedics; Mar2021, Vol. 24, p239-247, 9p |
| مصطلحات موضوعية: |
SURGICAL blood loss, RELATIVE medical risk, LENGTH of stay in hospitals, META-analysis, MEDICAL information storage & retrieval systems, CONFIDENCE intervals, SYSTEMATIC reviews, BLOOD transfusion, SURGICAL complications, TRANEXAMIC acid, TOTAL elbow replacement, MEDLINE, TOTAL shoulder replacement |
| مستخلص: |
Tranexamic acid (TXA) is an inexpensive antifibrinolytic agent that significantly reduces peri-operative blood loss and transfusion requirements after total hip and knee replacement. This meta-analysis demonstrates the effects of TXA on blood loss in total shoulder replacement (TSR) and total elbow replacement (TER). We systematically searched MEDLINE, EMBASE and CENTRAL from inception to September 03, 2020 for randomised controlled trial (RCTs) and observational studies. Our primary outcome was blood loss. Secondary outcomes included the need for blood transfusion, and post-operative venous thromboembolic (VTE) complications. Mean differences (MD) and relative risks with 95% confidence intervals (CIs) were reported. Four RCTs and five retrospective cohort studies (RCS) met eligibility criteria for TSRs, but none for TERs. RCT data determined that TXA administration significantly decreased estimated total blood loss (MD −358mL), post-operative blood loss (MD −113mL), change in haemoglobin (Hb) (MD −0.71 g/dL) and total Hb loss (MD −35.3g) when compared to placebo. RCS data demonstrated significant association between TXA administration and decreased in post-operative blood loss, change in Hb, change in Hct and length of stay. There was no significant difference in transfusion requirements or VTE complications. TXA administration in safe and effective in patients undergoing primary TSR: it significantly decreases blood loss compared with placebo and is associated with shorter length of stay compared with no treatment. No significant increase in VTE complications was found. TXA administration should be routinely considered for patients undergoing TSR. Further research is needed to demonstrate the treatment effect in patients undergoing TER. • TXA effectively reduces perioperative blood loss in patients undergoing shoulder replacement. • TXA does not significantly increase VTE events in patients undergoing shoulder replacement. • Further research is required to demonstrate the efficacy of TXA for total elbow replacements. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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