Evidence map›Paper›PMID 39115584›Full record

ArticleWorld journal of urology2024

Tranexamic acid reduces perioperative blood transfusions following open radical cystectomy - a propensity-score matched analysis.

Luisa Egen, Karoline Keller, Hanna Saskia Menold, Allison Quan, Carl-Erik Dempfle, Jochen Johannes Schoettler, Frederik Wessels, Benjamin Meister, Thomas Stefan Worst, Niklas Westhoff and 4 more

Abstract read
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In one paragraph

Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Review
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

14 authors.

Luisa EgenDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.ORCID http://orcid.org/0000-0002-9298-3715
Karoline KellerDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Hanna Saskia MenoldDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Allison QuanDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Carl-Erik DempfleCoagulation Center Mannheim, Mannheim, Germany.
Jochen Johannes SchoettlerDepartment of Anesthesiology, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Mannheim, Germany.
Frederik WesselsDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Benjamin MeisterDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Thomas Stefan WorstDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Niklas WesthoffDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Maximilian Christian KriegmairUrological Clinic Munich-Planegg, Germeringer Str. 32, 82152, Planegg, Germany.
Patrick HoneckDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Maurice Stephan MichelDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Karl-Friedrich KowalewskiDepartment of Urology and Urosurgery, Medical Faculty, University Medical Center Mannheim, Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. Karl-Friedrich.Kowalewski@umm.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRadical cystectomy is associated with bleeding and high transfusion rates, presenting challenges in patient management. This study investigated the prophylactic use of tranexamic acid during radical cystectomy.

methodsAll consecutive patients treated with radical cystectomy at a tertiary care university center were included from a prospectively maintained database. After an institutional change in the cystectomy protocol patients received 1 g of intravenous bolus of tranexamic acid as prophylaxis. To prevent bias, propensity score matching was applied, accounting for differences in preoperative hemoglobin, neoadjuvant chemotherapy, tumor stage, and surgeon experience. Key outcomes included transfusion rates, complications, and occurrence of venous thromboembolism.

resultsIn total, 420 patients were included in the analysis, of whom 35 received tranexamic acid. After propensity score matching, 32 patients and 32 controls were matched with regard to clinicopathologic characteristics. Tranexamic acid significantly reduced the number of patients who received transfusions compared to controls (19% [95%-Confidence interval = 8.3; 37.1] vs. 47% [29.8; 64.8]; p = 0.033). Intraoperative and postoperative transfusion rates were lower with tranexamic acid, though not statistically significant (6% [1.5; 23.2] vs. 19% [8.3; 37.1], and 16% [6.3; 33.7] vs. 38% [21.9; 56.1]; p = 0.257 and p = 0.089, respectively). The occurrence of venous thromboembolism did not differ significantly between the groups (9% [2.9; 26.7] vs. 3% [0.4; 20.9]; p = 0.606).

conclusionProphylactic tranexamic administration, using a simplified preoperative dosing regimen of 1 g as a bolus, significantly lowered the rate of blood transfusion after cystectomy. This exploratory study indicates the potential of tranexamic acid in enhancing outcomes of open radical cystectomy.

Indexed as

Antifibrinolytic AgentsBlood Loss, SurgicalBlood TransfusionCystectomyPropensity ScoreTranexamic AcidUrinary Bladder NeoplasmsAgedFemaleHumansMaleMiddle AgedRetrospective StudiesVenous ThromboembolismAntifibrinolytic AgentsTranexamic AcidBlood transfusionCystectomyTranexamic acidVenous thromboembolism

Identifiers

PMID39115584
PMCPMC11310255

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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.