文献类型：期刊文献

英文题名：Tranexamic acid may benefit patients with preexisting thromboembolic risk undergoing total joint arthroplasty: a systematic review and meta-analysis

作者：Dang, Xiangji[1,2];Liu, Mei[3];Yang, Qiang[4];Jiang, Jin[5];Liu, Yan[6];Sun, Hui[7];Tian, Jinhui[1]

第一作者：Dang, Xiangji

通信作者：Tian, JH[1];Liu, Y[2];Sun, H[3]

机构：[1]Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China;[2]Lanzhou Univ, Dept Pharmaceut, Hosp 2, Lanzhou, Gansu, Peoples R China;[3]Gansu Univ Chinese Med, Clin Med Sch 1, Lanzhou, Gansu, Peoples R China;[4]Lanzhou Univ, Dept Neurosurg, Hosp 2, Lanzhou, Gansu, Peoples R China;[5]Lanzhou Univ, Dept Orthoped, Hosp 2, Lanzhou, Gansu, Peoples R China;[6]Lanzhou Univ, Gansu High Throughput Screening & Creat Ctr Hlth P, Sch Pharm, Lanzhou, Peoples R China;[7]Lanzhou Univ, Cuiying Biomed Res Ctr, Hosp 2, Lanzhou, Gansu, Peoples R China

第一机构：Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China;[2]corresponding author), Lanzhou Univ, Gansu High Throughput Screening & Creat Ctr Hlth P, Sch Pharm, Lanzhou, Peoples R China;[3]corresponding author), Lanzhou Univ, Cuiying Biomed Res Ctr, Hosp 2, Lanzhou, Gansu, Peoples R China.

年份：2024

卷号：9

期号：6

起止页码：478

外文期刊名：EFORT OPEN REVIEWS

收录：;Scopus(收录号：2-s2.0-85196672187);WOS:【SCI-EXPANDED(收录号:WOS:001244479300005)】；

基金：This work was supported by the Natural Science Foundation of Gansu Province, China (22JR5RA982) , and the CuiYing Scientific and Technological Innovation Program of Lanzhou University Second Hospital, Gansu province, China (20CX9ZA113) .

语种：英文

外文关键词：tranexamic acid; venous thromboembolic event; total hip arthroplasty (THA); total knee arthroplasty (TKA); total joint arthroplasty (TJA); systematic review

摘要：Purpose: This study sought to determine if the use of tranexamic acid (TXA) in preexisting thromboembolic risk patients undergoing total joint arthroplasty (TJA) was linked to an increased risk of death or postoperative complications. center dot Methods: We conducted a comprehensive search for studies up to May 2023 in PubMed, Web of Science, EMBASE, and the Cochrane Library. We included randomized clinical trials, cohort studies, and case-control studies examining the use of TXA during TJA surgeries on high -risk patients. The Cochrane Risk of Bias instrument was used to gauge the excellence of RCTs, while the MINORS index was implemented to evaluate cohort studies. We used mean difference (MD) and relative risk (RR) as effect size indices for continuous and binary data, respectively, along with 95% CIs. center dot Results: Our comprehensive study, incorporating data from 11 diverse studies involving 812 993 patients, conducted a meta -analysis demonstrating significant positive outcomes associated with TXA administration. The findings revealed substantial reductions in critical parameters, including overall blood loss (MD = -237.33; 95% CI ( -425.44, -49.23)), transfusion rates (RR = 0.45; 95% CI (0.34, 0.60)), and 90 -day unplanned readmission rates (RR = 0.86; 95% CI (0.76, 0.97)). Moreover, TXA administration exhibited a protective effect against adverse events, showing decreased risks of pulmonary embolism (RR = 0.73; 95% CI (0.61, 0.87)), myocardial infarction (RR = 0.47; 95% CI (0.40-0.56)), and stroke (RR = 0.73; 95% CI (0.59-0.90)). Importantly, no increased risk was observed for mortality (RR = 0.53; 95% CI (0.24, 1.13)), deep vein thrombosis (RR = 0.69; 95% CI (0.44, 1.09)), or any of the evaluated complications associated with TXA use. center dot Conclusion: The results of this study indicate that the use of TXA in TJA patients with preexisting thromboembolic risk does not exacerbate complications, including reducing mortality, deep vein thrombosis, and pulmonary embolism. Existing evidence strongly supports the potential benefits of TXA in TJA patients with thromboembolic risk, including lowering blood loss, transfusion, and readmission rates.