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P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis

INTRODUCTION: Perioperative bleeding is a major risk during and after surgery, which can result in increased mortality and morbidity. Tranexamic acid (TXA) in the setting of trauma, minimises perioperative bleeding and its associated risks. However, there is a lack of evidence of its use in elective...

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Autores principales: Koh, Amanda, Adiamah, Alfred, Gomez, Dhanny, Sanyal, Sudip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030153/
http://dx.doi.org/10.1093/bjsopen/zrab032.106
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author Koh, Amanda
Adiamah, Alfred
Gomez, Dhanny
Sanyal, Sudip
author_facet Koh, Amanda
Adiamah, Alfred
Gomez, Dhanny
Sanyal, Sudip
author_sort Koh, Amanda
collection PubMed
description INTRODUCTION: Perioperative bleeding is a major risk during and after surgery, which can result in increased mortality and morbidity. Tranexamic acid (TXA) in the setting of trauma, minimises perioperative bleeding and its associated risks. However, there is a lack of evidence of its use in elective abdominal surgery. This meta-analysis of randomised controlled trials (RCTs) evaluated the effectiveness and safety of TXA in elective extrahepatic abdominal surgery. METHOD: A comprehensive search of Pubmed, Embase, and Clinicaltrial.gov databases was undertaken to identify RCTs from January 1947 to May 2020. The primary outcomes of intraoperative blood loss, and the secondary outcomes of need for perioperative blood transfusion, thromboembolic events, and mortality were extracted from included studies. Quantitative pooling of data was based on the random effects model. RESULTS: Nineteen studies reporting on 2205 patients were included. TXA reduced intraoperative blood loss (weighted mean difference (WMD) -188.35mL; 95% CI -254.65 to -121.72) and the need for perioperative blood transfusion (odds ratio (OR) 0.43; 95% CI 0.28 to 0.65). Importantly, TXA had no impact on the incidence of thromboembolic events (OR 0.49; 95% CI 0.18 to 1.35). There were no reported deaths in any of the studies. CONCLUSION: TXA reduces intra-operative blood loss without an increase in complications.
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spelling pubmed-80301532021-04-13 P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis Koh, Amanda Adiamah, Alfred Gomez, Dhanny Sanyal, Sudip BJS Open Poster Presentation INTRODUCTION: Perioperative bleeding is a major risk during and after surgery, which can result in increased mortality and morbidity. Tranexamic acid (TXA) in the setting of trauma, minimises perioperative bleeding and its associated risks. However, there is a lack of evidence of its use in elective abdominal surgery. This meta-analysis of randomised controlled trials (RCTs) evaluated the effectiveness and safety of TXA in elective extrahepatic abdominal surgery. METHOD: A comprehensive search of Pubmed, Embase, and Clinicaltrial.gov databases was undertaken to identify RCTs from January 1947 to May 2020. The primary outcomes of intraoperative blood loss, and the secondary outcomes of need for perioperative blood transfusion, thromboembolic events, and mortality were extracted from included studies. Quantitative pooling of data was based on the random effects model. RESULTS: Nineteen studies reporting on 2205 patients were included. TXA reduced intraoperative blood loss (weighted mean difference (WMD) -188.35mL; 95% CI -254.65 to -121.72) and the need for perioperative blood transfusion (odds ratio (OR) 0.43; 95% CI 0.28 to 0.65). Importantly, TXA had no impact on the incidence of thromboembolic events (OR 0.49; 95% CI 0.18 to 1.35). There were no reported deaths in any of the studies. CONCLUSION: TXA reduces intra-operative blood loss without an increase in complications. Oxford University Press 2021-04-08 /pmc/articles/PMC8030153/ http://dx.doi.org/10.1093/bjsopen/zrab032.106 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercialre-use, please contact journals.permissions@oup.com
spellingShingle Poster Presentation
Koh, Amanda
Adiamah, Alfred
Gomez, Dhanny
Sanyal, Sudip
P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis
title P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis
title_full P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis
title_fullStr P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis
title_full_unstemmed P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis
title_short P107 Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Extrahepatic Abdominal Surgery: a systematic review and meta-analysis
title_sort p107 safety and efficacy of tranexamic acid to minimise perioperative bleeding in extrahepatic abdominal surgery: a systematic review and meta-analysis
topic Poster Presentation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030153/
http://dx.doi.org/10.1093/bjsopen/zrab032.106
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