Evidence map›Paper›PMID 40168355›Full record

SynthesisPloS one2025

Comparative efficacy and safety of high-dose versus low-dose tranexamic acid in adolescent idiopathic scoliosis: A systematic review and meta-analysis.

Xin Liu, Zhong Ma, Jiangdong An, Zhiqiang Luo

Abstract readMeta-AnalysisSystematic ReviewComparative Study
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. 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

4 authors.

Xin LiuDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Zhong MaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Jiangdong AnDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Zhiqiang LuoDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.ORCID 0000-0002-5651-3847

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this meta-analysis was to evaluate the comparative effectiveness and safety of high-dose versus low-dose tranexamic acid (TXA) in adolescents undergoing treatment for idiopathic scoliosis.

methodsA comprehensive literature search was conducted across PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases up to March 2024. We sought to identify randomized controlled trials (RCTs) and retrospective controlled studies (RCSs) assessing the impact of high-dose compared to low-dose TXA on perioperative blood loss and transfusion requirements in spinal fusion procedures for adolescent idiopathic scoliosis. The study was registered in INPLASY (Registration number: INPLASY202480018).

resultsOur meta-analysis included data from six studies: two high-quality RCTs and four lower-quality RCSs, comprising a total of 611 participants. Subgroup analysis revealed that high-dose TXA significantly reduced intraoperative blood loss and transfusion rates in RCSs, whereas no significant differences were observed in RCTs. The combined findings showed that high-dose TXA was associated with a significant reduction in intraoperative blood loss [weighted mean difference (WMD) =  -215.48, 95% confidence interval (CI) (-367.58, -63.37), P <  0.001], as well as a decreased likelihood of transfusion [risk ratio (RR) =  0.40, 95% CI (0.30, 0.53), P <  0.001]. Operative time did not differ significantly, and no thromboembolic events were reported in either treatment group. The differences between high and low doses varied widely across studies.

conclusionThis meta-analysis indicates that high-dose TXA does not significantly reduce intraoperative blood loss, transfusion rates, or operative time compared to low-dose TXA in adolescent idiopathic scoliosis. While RCSs showed some benefit, our analysis places more emphasis on the results from RCTs, which did not show significant differences. Further high-quality RCTs are needed to confirm its effectiveness and safety.

Indexed as

Antifibrinolytic AgentsBlood Loss, SurgicalScoliosisTranexamic AcidAdolescentBlood TransfusionDose-Response Relationship, DrugHumansRandomized Controlled Trials as TopicSpinal FusionTreatment OutcomeAntifibrinolytic AgentsTranexamic Acid

Identifiers

PMID40168355
PMCPMC11960895

What OpenQuestion holds

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LicenceCC BY
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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.