Evidence map›Paper›PMID 34272686›Full record

ArticleSpine deformity2022

High- versus low-dose tranexamic acid as part of a Patient Blood Management strategy for reducing blood loss in patients undergoing surgery for adolescent idiopathic scoliosis.

Sundeep Tumber, Adam Bacon, Casey Stondell, Sampaguita Tafoya, Sandra L Taylor, Yashar Javidan, Eric Klineberg, Rolando Roberto

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Spine deformity, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 44% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
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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 2 institutions in 1 country.

Sundeep TumberDepartment of Anesthesiology, Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd., Sacramento, CA, USA. stumber@shrinenet.org.ORCID http://orcid.org/0000-0002-7925-6468
Adam BaconUniversity of California, Davis, Sacramento, CA, USA.
Casey StondellDepartment of Anesthesiology, Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd., Sacramento, CA, USA.
Sampaguita TafoyaDepartment of Anesthesiology, Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd., Sacramento, CA, USA.
Sandra L TaylorDepartment of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, CA, USA.
Yashar JavidanDepartment of Anesthesiology, Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd., Sacramento, CA, USA.
Eric KlinebergDepartment of Anesthesiology, Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd., Sacramento, CA, USA.
Rolando RobertoDepartment of Anesthesiology, Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd., Sacramento, CA, USA.
Shriners Hospitals for Children - Northern California · USUniversity of California, Davis · US

Funding

UC Davis Clinical and Translational Science CenterUL1TR001860 · NCATS · UNIVERSITY OF CALIFORNIA AT DAVIS · PI KENYON, NICHOLAS J., LYLES, COURTNEY REES · 2016 to 2025
$47.3M
NCATS NIH HHS UL1 TR001860
6 · The paper itself

Abstract

purposeThe administration of tranexamic acid (TXA) has been shown to be beneficial in reducing blood loss during surgery for adolescent idiopathic scoliosis (AIS), but optimal dosing has yet to be defined. This retrospective study compared high- versus low-dose TXA as part of a Patient Blood Management strategy for reducing blood loss in patients undergoing posterior spine fusion surgery.

methodsClinical records were reviewed for 223 patients with AIS who underwent posterior spinal fusion of five or more levels during a 6-year time period. We compared normalized blood loss, total estimated blood loss (EBL), and the need for transfusion between patients receiving high-dose TXA (loading dose of ≥ 30 mg/kg) versus low-dose TXA (loading dose < 30 mg/kg). Both groups received maintenance TXA infusions of 10 mg/kg/h until skin closure.

resultsPatient demographics, curves, and surgical characteristics were similar in both groups. The high-dose TXA group had a 36% reduction in normalized blood loss (1.8 cc/kg/level fused versus 2.8 cc/kg/level fused, p < 0.001) and a 37.5% reduction in total EBL (1000 cc versus 1600 cc, p < 0.001). Patients in the high-dose group had a 48% reduction in PRBC transfusion, with only 19% receiving a transfusion of PRBC compared to 67% in the low-dose group (p < 0.001).

conclusionWhen combined with other proven Patient Blood Management strategies, the use of high-dose TXA compared to low-dose TXA may be beneficial in reducing blood loss for patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion surgery. LEVEL OF EVIDENCE: Level III, retrospective cohort.

Indexed as

Antifibrinolytic AgentsScoliosisTranexamic AcidAdolescentBlood Loss, SurgicalBlood TransfusionHumansRetrospective StudiesAntifibrinolytic AgentsTranexamic AcidAdolescent idiopathic scoliosisBlood lossPatient Blood ManagementScoliosisTranexamic acid

Identifiers

PMID34272686
PMCPMC8742801
OpenAlexW3179199666

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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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.