Safety of tranexamic acid in surgically treated isolated spine trauma

Table 1 Baseline characteristics, n (%)

Groups	TXA group (n = 26)	Non-TXA group (n = 41)	P value
Demographics
Number of patients	26	41
Mean age (yr)	57	56	0.9
Male	15 (58)	26 (63)	0.2
Female	11 (42)	15 (36)
Regular use of antithrombotic
Yes	6 (23)	3 (7)	0.6
No	20 (77)	38 (93)
Mechanism of injury
RTA	5 (19)	4 (10)	0.45
Fall	18 (69)	34 (83)
Other (eizures, trauma)	3 (7)	3 (7)
Spine pathology
Spinal fracture	23 (88)	37 (90)	0.45
Spinal cord injury	3 (11)	3 (10)
SLIC/TLIC score
0-3	2 (7.6)	3 (7)	0.7
4	3 (11)	14 (34)
> 4	19 (74)	23 (56)
Not applicable	2 (7.6)	1 (2)
ASA grades
Grade 4	1 (4)	3 (7)	0.48
Grade 3	9 (35)	8 (19)
Grade 2	8 (30.6)	21 (51)
Grade 1	8 (30.6)	9 (22)

ASA: American Society of Anesthesiologists; RTA: Road traffic accidents; SLIC: Subaxial cervical spine injury classification; TLIC: Thoracolumbar injury classification; TXA: Tranexamic acid.

Table 2 Surgery characteristics, n (%)

Surgery characteristics	TXA group (n = 26)	Non-TXA group (n = 41)	P value
Type of operation
Corpectomy + fusion	2 (7.6)	1 (2)
Stabilization	6 (23)	24 (58)
Decompression	1 (4)	0
Fusion	1 (4)	1 (2)
Stabilization + fusion	6 (23)	0
Decompression + fusion	7 (27)	9 (22)
Decompression + stabilization	3 (11)	6 (14)
Approach
Open	26 (100)	24 (58)	0.04
Minimally invasive	0	17 (41)
Type of approach
Anterior	8 (31)	8 (19)	0.4
Posterior	17 (65)	32 (78)
Both	1 (4)	1 (2)
Levels involved	4.6 (2-9)	1.4 (1–7)	0.02
Duration of surgery (min)	203 (120–428)	159 (48–540)	0.03

TXA: Tranexamic acid.

Table 3 Comparison of outcomes between the tranexamic acid and non-tranexamic acid groups, n (%)

Outcomes	TXA group (n = 26)	Non-TXA group (n = 41)	P value
Intraoperative blood loss
< 150 mL	8 (31)	36 (88)	0.03
150-300 mL	15 (58)	4 (10)
300-500 mL	3 (11)	1 (2)
Intraoperative cell salvage	2 (7.6)	1 (2)
Intra-operative transfusion	1 (4)	2 (5)
Drain inserted	21 (81)	19 (46)
Time of drain removal
24 h	11 (42)	14 (34)	0.002
48 h	9 (35)	5 (12)
> 48 h	1 (4)	0
Admittance to discharge (d)	10	3	0.7

TXA: Tranexamic acid.

Table 4 Regression analysis

Model	R	R square	Adjusted R square	Std. Error of the estimate
1	0.3381	0.114	0.072	1.337

¹Predictors: Constant, estimated intraoperative blood loss, blood loss in drain, tranexamic acid.