Evidence map›Paper›PMID 39736682›Full record

SynthesisBMC musculoskeletal disorders2024

The optimal dose of intravenous tranexamic acid for reducing blood loss in spinal surgery: a network meta-analysis.

Bo Shi, Wenjuan Xie, Jia Kai, Lijun Li, Lin Sun

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Review
  2. 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

5 authors.

Bo ShiDepartment of Orthopaedics, Shanxi Provincial People's Hospital, Shani Medical University, No. 29, Double Tower Street, Taiyuan, Shanxi, 030012, China.
Wenjuan XieDepartment of Clinical Nutrition, Bethune Hospital, Shanxi Medical University, No. 99, Longcheng Street, Taiyuan City, 030032, China.
Jia KaiShanxi Medical University, 29 Shuangtasi Street, Yingze District, Taiyuan, Shanxi, China.
Lijun LiDepartment of Orthopaedics, Shanxi Provincial People's Hospital, Shani Medical University, No. 29, Double Tower Street, Taiyuan, Shanxi, 030012, China. chambers119@126.com.
Lin SunShanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China. sunlin_9999@163.com.

Funding

Health Commission of Shanxi Province 202204051002035
6 · The paper itself

Abstract

backgroundThis study aims to evaluate the optimal dose of intravenous tranexamic acid (TXA) for reducing blood loss in spinal surgery.

methodsA systematic search was conducted in the PubMed, Embase, Cochrane Library database from inception until November 2023. Randomized controlled trials (RCTs) incorporating diverse TXA dosing regimens for spinal surgery were included. The surface under the cumulative ranking curve (SUCRA) analysis was employed to determine ranking order. R software with gemtc package was used for all analyses, with a significance threshold set at P < 0.05.

resultsTwenty-four RCTs were considered eligible and finally included. All TXA treatments demonstrated superior efficacy compared to the placebo, with statistically significant differences (P < 0.05). SUCRA values indicated that Treatment I (100 mg/kg + 10 mg.kg/h) claimed the top rank (SUCRA, 80.3%), followed by Treatment F (15 mg/kg + 2 mg.kg/h) in second place (SUCRA, 76.7%), and Treatment E (10 mg/kg + 2 mg.kg/h) in third place (SUCRA, 75.2%). Conversely, the placebo ranked the lowest (SUCRA, 0.3%). Additionally, Treatment I (100 mg/kg + 10 mg.kg/h) held the top rank (SUCRA, 95.6%), followed by Treatment N (30 mg/kg + 10 mg.kg/h) in second place (SUCRA, 81.0%), and Treatment K (15 mg/kg + 6 mg.kg/h) in third place (SUCRA, 74.8%). Importantly, no statistically significant differences were observed between any TXA treatments and the placebo concerning the occurrence of deep vein thrombosis (DVT) (P > 0.05).

conclusionsThis network meta-analysis underscores that intravenous TXA is associated with decreased overall blood loss in multilevel spine surgery. Notably, the highest dose in this network meta-analysis (100 mg/kg + 10 mg.kg/h) emerged as the only regimen demonstrating significant benefits in pairwise comparisons with other TXA doses. Although this regimen did not significantly increase DVT risk, careful consideration of safety data for higher doses remains essential.

Indexed as

Antifibrinolytic AgentsBlood Loss, SurgicalRandomized Controlled Trials as TopicTranexamic AcidAdministration, IntravenousDose-Response Relationship, DrugHumansSpineTreatment OutcomeAntifibrinolytic AgentsTranexamic AcidDosing regimentsNetwork meta-analysisSpinal surgerySystematic reviewTranexamic acid

Identifiers

PMID39736682
PMCPMC11686872

What OpenQuestion holds

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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.