Mebel, D., Akagami, R., & Flexman, A.M. (2016). Use of tranexamic acid is associated with reduced blood product transfusion in complex skull base neurosurgical procedures: A retrospective cohort study. Anesthesia and Analgesia, 122, 503–508.
To determine the effect of tranexamic acid (TA) upon transfusion frequency and to explore the safety of TA in patients undergoing complex skull base neurosurgical procedures
The authors retrospectively examined records of patients undergoing complex skull base neurosurgical procedures. Patients were placed into one of two cohorts based upon administration of TA or not to determine the effect of TA on transfusion rates and TA-associated complications. Data were collected from patients undergoing the surgical procedure from 2001 to 2013.
PHASE OF CARE: Active antitumor treatment
Retrospective, observational cohort study
Multivariate regression was used to identify predictors of transfusion.
The administration of TA was associated with a decreased incidence of transfusions (95% confidence interval [CI] [0.15, 0.65], p = 0.002). No evidence of an adverse event profile (95% CI) existed for either thrombotic events (adjusted odds ratio (OR) = –0.09, 95% CI [–3.5, 1.8]) or seizure activity (OR = 1.1, 95% CI [–1.7, 3.9]) associated with TA.
In patients undergoing complex skull base neurosurgical procedures, this retrospective observational study compared transfusion frequency and TA-related adverse events between two cohorts based upon the administration of TA. A significantly decreased frequency of transfusions was associated with the administration of TA; no significant increase in TA-related adverse events was reported between the two cohorts.
Neurosurgical nurses caring for patients perioperatively may anticipate less need for transfusions in patients who receive TA perioperatively. However, the retrospective nature of this study needs confirmation of findings from future randomized, controlled trials.