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J. Cardiothorac. Vasc. Anesth. · Apr 2017
Safety of Tranexamic Acid in Pediatric Cardiac Surgery: A Nationwide Database Study.
- Takuma Maeda, Yusuke Sasabuchi, Hiroki Matsui, Yoshihiko Ohnishi, Shigeki Miyata, and Hideo Yasunaga.
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan; Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: takuma@ncvc.go.jp.
- J. Cardiothorac. Vasc. Anesth. 2017 Apr 1; 31 (2): 549-553.
ObjectivesThe present study aimed to examine the association between tranexamic acid (TXA) use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric cardiac surgery population using a national inpatient database in Japan. The authors also assessed the association between TXA use and other clinical outcomes (length of hospital stay and in-hospital mortality).DesignA nationwide, retrospective cohort study using propensity score analyses.SettingJapanese Diagnosis Procedure Combination inpatient database.ParticipantsPediatric patients who underwent cardiac surgery using cardiopulmonary bypass between July 2010 and March 2014 (N = 11,275).InterventionsNone.Measurements And Main ResultsPropensity-score matching created 3,739 pairs of patients with and without TXA administration. Propensity-matched analysis showed that the proportion of seizures was significantly higher in the TXA group than in the non-TXA group (1.6% v 0.2%, difference, 1.4%; 95% confidence interval, 1.0-1.9; p<0.001). However, none of the other outcomes was significantly different between the groups.ConclusionsTXA use is associated with a significantly increased risk of seizures. However, there is no difference in any other outcomes between the TXA and non-TXA groups.Copyright © 2017 Elsevier Inc. All rights reserved.
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