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      KCI등재 SCIE SCOPUS

      Postoperative Low-Dose Tranexamic Acid After Major Spine Surgery: A Matched Cohort Analysis

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      https://www.riss.kr/link?id=A107229278

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      다국어 초록 (Multilingual Abstract)

      Objective: This was a retrospective, cohort study investigating the efficacy and safety of continuous low-dose postoperative tranexamic acid (PTXA) on drain output and transfusion requirements following adult spinal deformity surgery. Methods: One hu...

      Objective: This was a retrospective, cohort study investigating the efficacy and safety of continuous low-dose postoperative tranexamic acid (PTXA) on drain output and transfusion requirements following adult spinal deformity surgery.
      Methods: One hundred forty-seven patients undergoing posterior instrumented thoracolumbar fusion of ≥3 vertebral levels at a single institution who received low-dose PTXA infusion (0.5–1 mg/kg/hr) for 24 hours were compared to 292 control patients who did not receive PTXA. The cohorts were propensity matched based on age, sex, American Society of Anesthesiologist physical status classification, body mass index, number of surgical levels, revision surgery, operative duration, and total intraoperative TXA dose (n=106 in each group). Primary outcome was 72-hour postoperative drain output. Secondary outcomes were number of allogeneic blood transfusions.
      Results: There was no significant difference in postoperative drain output in the PTXA group compared to control (660±420 mL vs. 710±490 mL, p=0.46). The PTXA group received significantly more crystalloid (6,100±3,100 mL vs. 4,600±2,400 mL, p<0.001) and red blood cell transfusions postoperatively (median [interquartile range]: 1 [0–2] units vs. 0 [0–1] units; incidence rate ratio [95% confidence interval], 1.6 [1.2–2.2]; p=0.001). Rates of adverse events were comparable between groups.
      Conclusion: Continuous low-dose PTXA infusion was not associated with reduced drain output after spinal deformity surgery. No difference in thromboembolic incidence was observed. A prospective dose escalation study is warranted to investigate the efficacy of higher dose PTXA.

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      참고문헌 (Reference)

      1 Wahlquist S, "When does intraoperative blood loss occur during pediatric scoliosis correction?" 5 : 387-391, 2017

      2 Wang Q, "Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery : a randomized controlled trial" 22 : 2035-2038, 2013

      3 Bess S, "The health impact of symptomatic adult spinal deformity: comparison of deformity types to United States population norms and chronic diseases" 41 : 224-233, 2016

      4 Lin JD, "Safety of a high-dose tranexamic acid protocol in complex adult spinal deformity : analysis of 100 consecutive cases" 6 : 189-194, 2018

      5 Naik BI, "Rotational thromboelastometry-guided blood product management in major spine surgery" 23 : 239-249, 2015

      6 Geck MJ, "Relationship between preoperative plasma fibrinogen concentration, perioperative bleeding, and transfusions in elective adult spinal deformity correction" 7 : 788-795, 2019

      7 Xie J, "Preliminary investigation of highdose tranexamic acid for controlling intraoperative blood loss in patients undergoing spine correction surgery" 15 : 647-654, 2015

      8 Leuven E, "PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching, common support graphing, and covariate imbalance testing. Statistical Software Components S432001" Boston College Department of Economics

      9 Cheriyan T, "Efficacy of tranexamic acid on surgical bleeding in spine surgery : a meta-analysis" 15 : 752-761, 2015

      10 Li G, "Efficacy of antifibrinolytic agents on surgical bleeding and transfusion requirements in spine surgery : a meta-analysis" 26 : 140-154, 2017

      1 Wahlquist S, "When does intraoperative blood loss occur during pediatric scoliosis correction?" 5 : 387-391, 2017

      2 Wang Q, "Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery : a randomized controlled trial" 22 : 2035-2038, 2013

      3 Bess S, "The health impact of symptomatic adult spinal deformity: comparison of deformity types to United States population norms and chronic diseases" 41 : 224-233, 2016

      4 Lin JD, "Safety of a high-dose tranexamic acid protocol in complex adult spinal deformity : analysis of 100 consecutive cases" 6 : 189-194, 2018

      5 Naik BI, "Rotational thromboelastometry-guided blood product management in major spine surgery" 23 : 239-249, 2015

      6 Geck MJ, "Relationship between preoperative plasma fibrinogen concentration, perioperative bleeding, and transfusions in elective adult spinal deformity correction" 7 : 788-795, 2019

      7 Xie J, "Preliminary investigation of highdose tranexamic acid for controlling intraoperative blood loss in patients undergoing spine correction surgery" 15 : 647-654, 2015

      8 Leuven E, "PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching, common support graphing, and covariate imbalance testing. Statistical Software Components S432001" Boston College Department of Economics

      9 Cheriyan T, "Efficacy of tranexamic acid on surgical bleeding in spine surgery : a meta-analysis" 15 : 752-761, 2015

      10 Li G, "Efficacy of antifibrinolytic agents on surgical bleeding and transfusion requirements in spine surgery : a meta-analysis" 26 : 140-154, 2017

      11 Houston BL, "Efficacy and safety of tranexamic acid in major non-cardiac surgeries at high risk for transfusion : a systematic review and meta-analysis" 34 : 51-62, 2020

      12 Elwatidy S, "Efficacy and safety of prophylactic large dose of tranexamic acid in spine surgery:a prospective, randomized, double-blind, placebo-controlled study" 33 : 2577-2580, 2008

      13 Norton RP, "Complications and intercenter variability of three-column resection osteotomies for spinal deformity surgery : a retrospective review of 423patients" 4 : 157-159, 2013

      14 Hui S, "Can tranexamic acid conserve blood and save operative time in spinal surgeries? A meta-analysis" 18 : 1325-1337, 2018

      15 Hu SS, "Blood loss in adult spinal surgery" 13 (13): S3-S5, 2004

      16 Chiu CK, "Assessment of intraoperative blood loss at different surgical stages during posterior spinal fusion surgery in the treatment of adolescent idiopathic scoliosis" 41 : E566-E573, 2016

      17 Henry DA, "Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion" 1 (1): CD001886-, 2011

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      학술지 이력

      학술지 이력
      연월일 이력구분 이력상세 등재구분
      2023 평가예정 해외DB학술지평가 신청대상 (해외등재 학술지 평가)
      2020-01-01 평가 등재학술지 유지 (해외등재 학술지 평가) KCI등재
      2018-03-31 학술지명변경 한글명 : 대한척추신경외과학회지 -> Neurospine KCI등재
      2018-01-01 평가 등재학술지 선정 (계속평가) KCI등재
      2016-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
      2015-12-01 평가 등재후보 탈락 (기타)
      2013-01-01 평가 등재후보학술지 유지 (기타) KCI등재후보
      2012-09-19 학술지명변경 외국어명 : Korean journal of spine -> Neurospine KCI등재후보
      2012-01-01 평가 등재후보학술지 유지 (기타) KCI등재후보
      2011-01-01 평가 등재후보 1차 PASS (등재후보1차) KCI등재후보
      2009-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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      학술지 인용정보

      학술지 인용정보
      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0.13 0.13 0.14
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.13 0.12 0.411 0
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