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Combined Use of Intravenous and Topical Tranexamic Acid Efficiently Reduce Blood Loss in Patients Aged over 60 operated with 2-level lumbar fusion
Yifei Huang
Xinjiang Uygur Autonomous Region Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3980-9125
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Journal of Orthopaedic Surgery and Research.
Purpose: The current study was conducted to assess the efficacy and safety of the intravenous (IV) administration combined with topical administration of tranexamic acid （TXA）in patients (aged over 60) scheduled for 2-level lumbar fusion surgery.
Methods: 280 patients scheduled for 2-level lumbar fusion surgery were randomized into four groups, including an IV group, a local group, a combined group, and a control group. Patients in the combined group, in the IV group, in the topical group, and in the control group were administrated with 15 mg/kg of IV-TXA + 2 g TXA in local,15 mg/kg IV-TXA, 2 g TXA in local ,and 100 ml IV, respectively. The results of total blood loss (TBL) , maximum hemoglobin drop, the transfusion rate, and the number of allogeneic blood units were compared. Deep venous thrombosis (DVT) and pulmonary embolism (PE) events were monitored and recorded.
Results: The TBL was 635.49 ± 143.60, 892.62 ± 166.85, 901.11 ± 186.25, and 1,225.11 ± 186.25 mL for the combined group, the IV group, the topical group, and the control group, respectively.(p = 0.015, p = 0.001 respectively).The average maximum hemoglobin drop in the four above groups was 2.18 ± 0.24, 2.80 ± 0.37, 2.40 ± 0.64 ，and 3.40 ± 1.32 g/dL, respectively. No PE event was reported during the follow-up. Although asymptomatic DVT events was reported by 1, 2, and 2 patients in the combined group, topical group, and control group, respectively, there is no intergroup difference.
Conclusions: The combined use of TXA effectively reduced total blood loss and blood transfusion rate in patients aged over 60 scheduled for 2-level lumbar fusion, without increasing the incidence of DVT and PE formation.
Keywords
Tranexamic acid, Total hip arthroplasty, Blood loss, Combined treatment
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CURRENT STATUS: Published
Version 2
Posted 17 Apr, 2020
Published
On 20 Aug, 2020
No community comments so far
Editorial decision: Accept
On 14 Jun, 2020
Reviewers invited
Invitations sent on 30 May, 2020
Editor assigned
On 14 Apr, 2020
Submission checks complete
On 13 Apr, 2020
Editor invited
On 13 Apr, 2020
No comments provided
Editorial decision: Major revision
On 23 Mar, 2020
Reviewer #2 agreed
On 05 Mar, 2020
Review #1 received
Received 05 Mar, 2020
Reviewers invited
Invitations sent on 05 Mar, 2020
Reviewer #1 agreed
On 05 Mar, 2020
Editor assigned
On 30 Jan, 2020
Editor invited
On 29 Jan, 2020
Submission checks complete
On 28 Jan, 2020
First submitted
On 24 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
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This preprint is under consideration at Journal of Orthopaedic Surgery and Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Combined Use of Intravenous and Topical Tranexamic Acid Efficiently Reduce Blood Loss in Patients Aged over 60 operated with 2-level lumbar fusion
Yifei Huang
Xinjiang Uygur Autonomous Region Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3980-9125
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 17 Apr, 2020
Published
On 20 Aug, 2020
No community comments so far
Editorial decision: Accept
On 14 Jun, 2020
Reviewers invited
Invitations sent on 30 May, 2020
Editor assigned
On 14 Apr, 2020
Submission checks complete
On 13 Apr, 2020
Editor invited
On 13 Apr, 2020
No comments provided
Editorial decision: Major revision
On 23 Mar, 2020
Reviewer #2 agreed
On 05 Mar, 2020
Review #1 received
Received 05 Mar, 2020
Reviewers invited
Invitations sent on 05 Mar, 2020
Reviewer #1 agreed
On 05 Mar, 2020
Editor assigned
On 30 Jan, 2020
Editor invited
On 29 Jan, 2020
Submission checks complete
On 28 Jan, 2020
First submitted
On 24 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Journal of Orthopaedic Surgery and Research.
Purpose: The current study was conducted to assess the efficacy and safety of the intravenous (IV) administration combined with topical administration of tranexamic acid （TXA）in patients (aged over 60) scheduled for 2-level lumbar fusion surgery.
Methods: 280 patients scheduled for 2-level lumbar fusion surgery were randomized into four groups, including an IV group, a local group, a combined group, and a control group. Patients in the combined group, in the IV group, in the topical group, and in the control group were administrated with 15 mg/kg of IV-TXA + 2 g TXA in local,15 mg/kg IV-TXA, 2 g TXA in local ,and 100 ml IV, respectively. The results of total blood loss (TBL) , maximum hemoglobin drop, the transfusion rate, and the number of allogeneic blood units were compared. Deep venous thrombosis (DVT) and pulmonary embolism (PE) events were monitored and recorded.
Results: The TBL was 635.49 ± 143.60, 892.62 ± 166.85, 901.11 ± 186.25, and 1,225.11 ± 186.25 mL for the combined group, the IV group, the topical group, and the control group, respectively.(p = 0.015, p = 0.001 respectively).The average maximum hemoglobin drop in the four above groups was 2.18 ± 0.24, 2.80 ± 0.37, 2.40 ± 0.64 ，and 3.40 ± 1.32 g/dL, respectively. No PE event was reported during the follow-up. Although asymptomatic DVT events was reported by 1, 2, and 2 patients in the combined group, topical group, and control group, respectively, there is no intergroup difference.
Conclusions: The combined use of TXA effectively reduced total blood loss and blood transfusion rate in patients aged over 60 scheduled for 2-level lumbar fusion, without increasing the incidence of DVT and PE formation.
Figure 1
Due to technical limitations, tables are only available as a download in the supplemental files section