Single Dose of Tranexamic Acid Effectively Reduces Blood Loss in Patients Undergoing Spine Surgery: A Prospective Randomized Controlled Trial

Abstract

Objective: To evaluate the efficacy of oral administration of tranexamic acid (TXA) in spine surgery to achieve blood loss reduction.

Methods: Sixty patients undergoing major surgery of the spine were randomly assigned into 2 groups. Group 1 was assigned as the control group and the other group comprised patients who received oral administration of TXA 2 hours before surgery. Outcome measures included intraoperative blood loss, postoperative blood loss, hematologic parameters, blood transfusion needed, and surgical complications.

Results: Sixty patients linked up with the inclusion criteria. Intraoperative blood loss was significantly lower in the TXA oral group than in the control group; total blood loss in the TXA group was 930.66 ± 614 mL, which was lower than in the control group, with 1075.66 ± 956.11 mL. The mean reduction of hemoglobin was almost the same in both groups. Similarly, the total transfusion package received was lower, and the number of complications and length of stay were akin in both groups. A logistic regression model was performed with patients who had blood loss >1000 mL and surgery time >230 minutes. This result was related to the risk of bleeding, with an odds ratio of 1.31, 95% confidence interval, 1.004-1.023, P = 0.004, independent of the group.

Conclusions: Oral TXA is as an effective measure for reducing total blood loss among patients undergoing elective spine surgery.

Keywords: Clinical outcomes; Controlled trial; Evidence-based medicine; Prospective study; Randomized controlled trial; Spine surgery; Tranexamic acid TXA.