Evidence map›Paper›PMID 28744807›Full record

Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017

The effectiveness of low-dose and high-dose tranexamic acid in posterior lumbar interbody fusion: a double-blinded, placebo-controlled randomized study.

Ki-Tack Kim, Cheung-Kue Kim, Yong-Chan Kim, Hyung-Suk Juh, Hyo-Jong Kim, Hyeon-Soo Kim, Se Jung Hong, Hwee Weng Dennis Hey

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 6 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 6 syntheses or guidelines pooled it, 49 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Review
  18. Article
  19. [Effect of hydrogen peroxide on anti-infection and reducing postoperative drainage in multi-segmental lumbar surgery].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Ki-Tack KimDepartment of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
Cheung-Kue KimDepartment of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea. kchk223@hanmail.net.
Yong-Chan KimDepartment of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
Hyung-Suk JuhDepartment of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea.
Hyo-Jong KimDepartment of Orthopedic Surgery, Park Weon Wook Hospital, Busan, South Korea.
Hyeon-Soo KimDepartment of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, South Korea.
Se Jung HongDepartment of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
Hwee Weng Dennis HeyUniversity Orthopaedics, Hand and Reconstructive Microsurgery Cluster (UOHC), National University Health System (NUHS), Singapore, Singapore.
Kyung Hee University Hospital at Gangdong · KRKyung Hee University · KRNational University Health System · SGSamsung (South Korea) · KRSungkyunkwan University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTranexamic acid is a proven drug used for reduction of intraoperative blood loss in spinal surgery. However, optimal dosing considering risk/benefits is not well established owing to the heterogeneity in patient selection and surgical procedures of previous studies. This study aimed to evaluate the effectiveness and safety of various tranexamic acid regimens in reducing perioperative blood loss in single-level posterior lumbar interbody fusion (PLIF).

methodsPatients were randomly grouped into three different interventions: low-dose tranexamic acid (LD), high-dose tranexamic acid (HD), and placebo-controlled (PC) groups. The HD and LD groups received 10 and 5 mg/kg of bolus loading dose and 2 and 1 mg/kg of continuous infusion until 5 h after surgery, respectively. Data on patient demographics and preoperative and 24-h postoperative laboratory values were collected. Outcome parameters include intraoperative blood loss, 24-h postoperative blood loss, and blood loss during removal of the last drain.

resultsSeventy-two patients (mean age 63.3 ± 7.6 years) showed similar baseline characteristics. Intraoperatively, blood loss was reduced by the administration of tranexamic acid (P = 0.04), contributed predominantly by a difference between the LD and HD groups (123 mL; P < 0.01). The 24-h postoperative blood loss was reduced (P < 0.01), contributed predominantly by a difference between the PC and LD groups (144 mL; P = 0.02). During the removal of the last drain, statistical difference was found between the PC and HD groups (125 mL; P = 0.00). No complications or side effects from tranexamic acid use were noted.

conclusionTranexamic acid administration for single-level PLIF was effective and safe in reducing perioperative blood loss in a dose-dependent manner. An HD regimen comprising 10 mg/kg of bolus loading dose and 2 mg/kg/h of continuous infusion is recommended. LEVEL OF EVIDENCE: Level 1 study according to Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.

Indexed as

Antifibrinolytic AgentsBlood Loss, SurgicalSpinal FusionTranexamic AcidAgedHumansMiddle AgedPostoperative HemorrhageAntifibrinolytic AgentsTranexamic AcidPerioperative blood lossPlacebo-controlledPosterior lumbar interbody fusionSpinal surgeryTranexamic acid

Identifiers

PMID28744807
OpenAlexW2739475180

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.