Alexander N Berk, Alexander A Hysong, Joseph B Kahan, Anna M Ifarraguerri, David P Trofa, Nady Hamid, Allison J Rao, Bryan M Saltzman
{"title":"氨甲环酸在初级解剖和反向全肩关节置换术中的疗效：I级随机对照试验的系统回顾和荟萃分析。","authors":"Alexander N Berk, Alexander A Hysong, Joseph B Kahan, Anna M Ifarraguerri, David P Trofa, Nady Hamid, Allison J Rao, Bryan M Saltzman","doi":"10.1177/17585732231200497","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to systematically review the available level I evidence regarding the impact of tranexamic acid (TXA) on early postoperative outcomes in patients undergoing anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).</p><p><strong>Methods: </strong>A systematic review of the literature through April 2023 was performed to identify level I RCTs examining the use of TXA at the time of primary TSA or RTSA.</p><p><strong>Results: </strong>Among 5 included studies, a total of 435 patients (219 TXA, 216 control) were identified. Superior hematologic outcomes were observed among the TXA cohort, including lower 24-hour drain output (MD -112.70 mL: <i>p </i>< 0.001), lower pre- to postoperative change in hemoglobin (MD: -0.68 g/dL, <i>p </i>< 0.001), and less total perioperative blood loss (MD: -249.56 mL, <i>p </i>< 0.001). Postoperative Visual Analog Scale for pain (VAS-pain) scores were lower in the TXA group, but not significantly (MD: -0.46, <i>p </i>= 0.17). Postoperative blood transfusion was required in 3/219 TXA patients (1.4%) and 7/216 control patients (3.2%) (RR: 0.40, <i>p </i>= 0.16).</p><p><strong>Conclusion: </strong>Perioperative TXA reduces drain output and total blood loss without increasing the risk of adverse events. TXA was not shown to decrease postoperative transfusion rates when compared to placebo controls.</p><p><strong>Level of evidence: </strong>Level I, meta-analysis.</p>","PeriodicalId":13249,"journal":{"name":"IEEE Spectrum","volume":"16 1","pages":"481-492"},"PeriodicalIF":2.6000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528776/pdf/","citationCount":"0","resultStr":"{\"title\":\"The efficacy of tranexamic acid in primary anatomic and reverse total shoulder arthroplasty: A systematic review and meta-analysis of level I randomized controlled trials.\",\"authors\":\"Alexander N Berk, Alexander A Hysong, Joseph B Kahan, Anna M Ifarraguerri, David P Trofa, Nady Hamid, Allison J Rao, Bryan M Saltzman\",\"doi\":\"10.1177/17585732231200497\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The purpose of this study was to systematically review the available level I evidence regarding the impact of tranexamic acid (TXA) on early postoperative outcomes in patients undergoing anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).</p><p><strong>Methods: </strong>A systematic review of the literature through April 2023 was performed to identify level I RCTs examining the use of TXA at the time of primary TSA or RTSA.</p><p><strong>Results: </strong>Among 5 included studies, a total of 435 patients (219 TXA, 216 control) were identified. Superior hematologic outcomes were observed among the TXA cohort, including lower 24-hour drain output (MD -112.70 mL: <i>p </i>< 0.001), lower pre- to postoperative change in hemoglobin (MD: -0.68 g/dL, <i>p </i>< 0.001), and less total perioperative blood loss (MD: -249.56 mL, <i>p </i>< 0.001). Postoperative Visual Analog Scale for pain (VAS-pain) scores were lower in the TXA group, but not significantly (MD: -0.46, <i>p </i>= 0.17). Postoperative blood transfusion was required in 3/219 TXA patients (1.4%) and 7/216 control patients (3.2%) (RR: 0.40, <i>p </i>= 0.16).</p><p><strong>Conclusion: </strong>Perioperative TXA reduces drain output and total blood loss without increasing the risk of adverse events. TXA was not shown to decrease postoperative transfusion rates when compared to placebo controls.</p><p><strong>Level of evidence: </strong>Level I, meta-analysis.</p>\",\"PeriodicalId\":13249,\"journal\":{\"name\":\"IEEE Spectrum\",\"volume\":\"16 1\",\"pages\":\"481-492\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528776/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IEEE Spectrum\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/17585732231200497\",\"RegionNum\":4,\"RegionCategory\":\"工程技术\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IEEE Spectrum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17585732231200497","RegionNum":4,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
The efficacy of tranexamic acid in primary anatomic and reverse total shoulder arthroplasty: A systematic review and meta-analysis of level I randomized controlled trials.
Purpose: The purpose of this study was to systematically review the available level I evidence regarding the impact of tranexamic acid (TXA) on early postoperative outcomes in patients undergoing anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).
Methods: A systematic review of the literature through April 2023 was performed to identify level I RCTs examining the use of TXA at the time of primary TSA or RTSA.
Results: Among 5 included studies, a total of 435 patients (219 TXA, 216 control) were identified. Superior hematologic outcomes were observed among the TXA cohort, including lower 24-hour drain output (MD -112.70 mL: p < 0.001), lower pre- to postoperative change in hemoglobin (MD: -0.68 g/dL, p < 0.001), and less total perioperative blood loss (MD: -249.56 mL, p < 0.001). Postoperative Visual Analog Scale for pain (VAS-pain) scores were lower in the TXA group, but not significantly (MD: -0.46, p = 0.17). Postoperative blood transfusion was required in 3/219 TXA patients (1.4%) and 7/216 control patients (3.2%) (RR: 0.40, p = 0.16).
Conclusion: Perioperative TXA reduces drain output and total blood loss without increasing the risk of adverse events. TXA was not shown to decrease postoperative transfusion rates when compared to placebo controls.
期刊介绍：
IEEE Spectrum Magazine, the flagship publication of the IEEE, explores the development, applications and implications of new technologies. It anticipates trends in engineering, science, and technology, and provides a forum for understanding, discussion and leadership in these areas.
IEEE Spectrum is the world''s leading engineering and scientific magazine. Read by over 300,000 engineers worldwide, Spectrum provides international coverage of all technical issues and advances in computers, communications, and electronics. Written in clear, concise language for the non-specialist, Spectrum''s high editorial standards and worldwide resources ensure technical accuracy and state-of-the-art relevance.
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