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Preoperative tranexamic acid does not reduce transfusion rates in major oncologic surgery: Results of a randomized, double‐blind, and placebo‐controlled trial
Author(s) -
Wright Gerald Paul,
Wolf Andrea M.,
Waldherr Tracy L.,
RitzHolland Deborah,
Laney Eric D.,
Chapman Heidi A.,
Lane Brian R.,
Assifi M. Mura,
Chung Mathew H.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26142
Subject(s) - tranexamic acid , medicine , interquartile range , anesthesia , placebo , perioperative , blood transfusion , pulmonary embolism , venous thrombosis , surgery , randomized controlled trial , antifibrinolytic , thrombosis , blood loss , alternative medicine , pathology
Abstract Background and Objectives Allogeneic blood transfusions are associated with worse postoperative outcomes in oncologic surgery. The aim of this study was to introduce a preoperative intervention to reduce transfusion rates in this population. Methods Adult patients undergoing major oncologic surgery in five categories with similar transfusion rates were recruited. Enrollees received a single preoperative intravenous dose of placebo or tranexamic acid (1000 mg). The primary outcome measure was perioperative transfusion rate. Secondary outcome measures included: estimated blood loss, thromboembolic events, morbidity, hospital length of stay, and readmission rate. Results Seventy‐six patients were enrolled, 39 in the tranexamic acid group and 37 in the placebo group, respectively. Demographics and surgery type were equivalent between groups. The transfusion rates were 8 out of 39 (20.5%) in the tranexamic acid group and 5 out of 37 (13.5%) in the placebo group, respectively ( P = .418). Median estimated blood loss was 400 mL (interquartile range [IQR] = 150‐600) in the tranexamic acid group compared with 300 mL (IQR = 150‐800) in the placebo group ( P = .983). There was one pulmonary embolism in each arm and no deep venous thrombosis ( P > .999). Conclusion Preoperative administration of tranexamic acid at a 1000 mg intravenous dose does not decrease transfusion rates or estimated blood loss in patients undergoing major oncologic surgery.