Evidence map›Paper›PMID 38427155›Full record

ReviewSpine deformity2024

The cost-utility of intraoperative tranexamic acid in adult spinal deformity patients undergoing long posterior spinal fusion.

Miguel A Cartagena-Reyes, Juan A Silva-Aponte, Gabriel I Nazario-Ferrer, Gregory A Benes, Ananya Choudhary, Micheal Raad, Steven M Frank, Farah N Musharbash, Amit Jain

Abstract readReview
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In one paragraph

Review in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 60% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

9 authors at 1 institution in 1 country.

Miguel A Cartagena-ReyesDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Juan A Silva-AponteDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Gabriel I Nazario-FerrerDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Gregory A BenesDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Ananya ChoudharyDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Micheal RaadDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Steven M FrankDepartment of Anesthesiology/Critical Care Medicine, The Johns Hopkins University, 1800 Orleans St., Zayed 6208, Baltimore, MD, 21287, USA.
Farah N MusharbashDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA.
Amit JainDepartment of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, JHOC 5230, Baltimore, MD, 21287, USA. amitjain@jhmi.edu.ORCID 0000-0002-9983-3365
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to evaluate the cost-utility of intraoperative tranexamic acid (TXA) in adult spinal deformity (ASD) patients undergoing long posterior (≥ 5 vertebral levels) spinal fusion.

methodsA decision-analysis model was built for a hypothetical 60-year-old adult patient with spinal deformity undergoing long posterior spinal fusion. A comprehensive review of the literature was performed to obtain event probabilities, costs and health utilities at each node. Health utilities were utilized to calculate Quality-Adjusted Life Years (QALYs). A base-case analysis was carried out to obtain the incremental cost and effectiveness of intraoperative TXA. Probabilistic sensitivity analysis was performed to evaluate uncertainty in our model and obtain mean incremental costs, effectiveness, and net monetary benefits. One-way sensitivity analyses were also performed to identify the variables with the most impact on our model.

resultsUse of intraoperative TXA was the favored strategy in 88% of the iterations. The mean incremental utility ratio for using intraoperative TXA demonstrated higher benefit and lower cost while being lower than the willingness-to-pay threshold set at $50,000 per quality adjusted life years. Use of intraoperative TXA was associated with a mean incremental net monetary benefit (INMB) of $3743 (95% CI 3492-3995). One-way sensitivity analysis reported cost of blood transfusions due to post-operative anemia to be a major driver of cost-utility analysis.

conclusionUse of intraoperative TXAs is a cost-effective strategy to reduce overall perioperative costs related to post-operative blood transfusions. Administration of intraoperative TXA should be considered for long fusions in ASD population when not explicitly contra-indicated due to patient factors.

Indexed as

Antifibrinolytic AgentsCost-Benefit AnalysisQuality-Adjusted Life YearsSpinal FusionTranexamic AcidBlood Loss, SurgicalDecision Support TechniquesHumansIntraoperative CareMiddle AgedSpinal CurvaturesAntifibrinolytic AgentsTranexamic AcidAdult spinal deformityCost–utilityTranexamic acid

Identifiers

PMID38427155
OpenAlexW4392385370

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.