The Safety and Efficacy of Tranexamic Acid in Oncology Patients Undergoing Endoprosthetic Reconstruction and a ROTEM-Based Evaluation of Their Hemostatic Profile: A Pilot Study
| Autor: | Dimitrios V. Papadopoulos, Argirios E. Tsantes, Ioannis G Trikoupis, Panayiotis J. Papagelopoulos, Andreas G Tsantes, Georgios K. Nikolopoulos, Stefanos Bonovas, Argyri Gialeraki, Stavros Goumenos, Vasilios A Kontogeorgakos, Daniele Piovani |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
Antifibrinolytic medicine.drug_class medicine.medical_treatment rotational thromboelastometry Article tranexamic acid Fibrinolysis medicine blood loss RC254-282 business.industry Incidence (epidemiology) Neoplasms. Tumors. Oncology. Including cancer and carcinogens Retrospective cohort study endoprosthetic reconstruction Red blood cell Thromboelastometry medicine.anatomical_structure Oncology Anesthesia Hemostasis musculoskeletal oncology hemostasis business Tranexamic acid medicine.drug |
| Zdroj: | Cancers Cancers, Vol 13, Iss 3951, p 3951 (2021) Volume 13 Issue 16 |
| ISSN: | 2072-6694 |
| Popis: | Background: An endoprosthetic reconstruction in musculoskeletal oncology patients is associated with significant blood loss. The purpose of this study is to evaluate the safety and efficacy of tranexamic acid (TXA) for these patients and to assess any changes in their hemostatic profile using rotational thromboelastometry (ROTEM). Methods: A retrospective observational study was performed including 61 patients with primary or metastatic bone tumors who underwent surgery. Group A (n = 30) received both intravenous and local TXA whereas Group B (n = 31) was the control group. The primary outcomes were perioperative blood loss and blood unit transfusions and the secondary outcomes included the incidence of thromboembolic complications and a change in blood coagulability as reflected by ROTEM parameters. Results: The median difference in blood loss between the two groups was 548.5 mL, indicating a 29.2% reduction in the 72 h blood loss following TXA administration (p < 0.001). TXA also led to a reduced transfusion of 1 red blood cell (RBC) unit per patient (p < 0.001). The two groups had similar rates of thromboembolic complications (p = 0.99). The antifibrinolytic properties of TXA were confirmed by the significantly higher INTEM, FIBTEM and EXTEM LI60 (p < 0.001, p = 0.005 and p < 0.001, respectively) values in the TXA group. Conclusion: Tranexamic acid was associated with a significant reduction in perioperative blood loss and transfusion requirements without a complete shutdown of the fibrinolysis. Larger studies are warranted to assess the frequency of these outcomes in musculoskeletal oncology patients. |
| Databáze: | OpenAIRE |
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