Evidence map›Paper›PMID 40276619›Full record

ArticleBJA open2025

Exploratory randomised trial of tranexamic acid to decrease postoperative delirium in adults undergoing lumbar fusion-a trial stopped early.

Bradley J Hindman, Catherine R Olinger, Royce W Woodroffe, Mario Zanaty, Carolina Deifelt Streese, Zeb R Zacharias, Jon C D Houtman, Linder H Wendt, Patrick P Ten Eyck, Debra J O'Connell-Moore and 9 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04272606 (Prospective, Randomized, Double Blind Study on the Effects of Tranexamic Acid on Intraoperative Blood Loss During Lumbar Spinal Fusion And Instrumentation), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT04272606 phase2completednot on this map

Prospective, Randomized, Double Blind Study on the Effects of Tranexamic Acid on Intraoperative Blood Loss During Lumbar Spinal Fusion And Instrumentation

TypeinterventionalSponsorCatherine R. OlingerRan2020 to 2023Enrolled123ConditionsDegenerative Disc DiseaseArmsTranexamic Acid, Saline Solution, Visual Acuity Exam, 3 Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Bradley J HindmanDepartment of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Catherine R OlingerDepartment of Orthopedics and Rehabilitation, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Royce W WoodroffeDepartment of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Mario ZanatyDepartment of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Carolina Deifelt StreeseDepartment of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Zeb R ZachariasHuman Immunology Core Laboratory, University of Iowa, Iowa City, IA, USA.
Jon C D HoutmanHuman Immunology Core Laboratory, University of Iowa, Iowa City, IA, USA.
Linder H WendtInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Patrick P Ten EyckInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Debra J O'Connell-MooreInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Emanuel J RayDepartment of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Sarah J LeeDepartment of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Daniel F WaldschmidtInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Lauren G HavertapeInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Lanchi B NguyenInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Pei-Fu ChenDepartment of Anesthesiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Matthew I BanksDepartment of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Robert D SandersCentral Clinical School and National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.
Matthew A HowardDepartment of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Funding

University of Iowa Institute for Clinical and Translational ScienceUM1TR004403 · NCATS · UNIVERSITY OF IOWA · PI Marlan R Hansen, Patricia Winokur · 2023 to 2026
$16.1M
NCATS NIH HHS UM1 TR004403
6 · The paper itself

Abstract

Background: Postoperative delirium may be mediated by systemic inflammation and neuroinflammation. By inhibiting the proinflammatory actions of plasmin, tranexamic acid (TXA) may decrease postoperative delirium. To explore this hypothesis, we modified an ongoing randomised trial of TXA on blood loss, adding measures of delirium, cognition, systemic inflammation, and astrocyte activation. Methods: Adults undergoing elective posterior lumbar fusion randomly received intraoperative i.v. TXA ( Results: Postoperative blood loss was ∼38% less in the TXA group compared with the placebo group with medians of 128 and 207 ml level Conclusions: A potential 33% relative decrease in postoperative delirium incidence justifies an adequately powered clinical trial to determine if intraoperative TXA decreases delirium in adults undergoing lumbar fusion. Clinical trial registration: NCT04272606.

Indexed as

clinical trialcytokinesdeliriumS100Bspinal fusiontranexamic acid

Identifiers

PMID40276619
PMCPMC12019205

What OpenQuestion holds

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Registered trials

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.