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- Title
Tranexamic acid and post-tonsillectomy hemorrhage: propensity score and instrumental variable analyses.
- Authors
Koizumi, Megumi; Ishimaru, Miho; Matsui, Hiroki; Fushimi, Kiyohide; Yamasoba, Tatsuya; Yasunaga, Hideo
- Abstract
Purpose: Although post-tonsillectomy hemorrhage occurs rarely, it can be life-threatening. Previous studies showed that tranexamic acid (TXA) had insignificant association with the rate of post-tonsillectomy hemorrhage, but those findings were limited by small sample sizes. The purpose of this study was to examine the effectiveness of TXA in preventing post-tonsillectomy hemorrhage using nationwide database.Methods: Data of a retrospective cohort of 117,598 patients from 750 hospitals, who had undergone tonsillectomy between 2010 and 2016, were drawn from the Diagnosis Procedure Combination database in Japan and studied.Results: Propensity score-matched analysis showed no significant differences in proportions of reoperation or blood transfusion after tonsillectomy between the treatment (TXA from the day of tonsillectomy) and control groups (1.50% vs. 1.47%, p = 0.64). Instrumental variable analysis also showed no significant differences (odds ratio, 0.98; 95% confidence interval, 0.86-1.13; p = 0.82). Higher proportions of reoperation or blood transfusion were significantly associated with male sex, older age, emergency hospitalization, prolonged anesthesia, and medium hospital volume (annual number of tonsillectomies).Conclusions: Administration of TXA from the day of tonsillectomy is not associated with reduction in reoperation or blood transfusion rates.
- Subjects
JAPAN; TRANEXAMIC acid; INSTRUMENTAL analysis; HEMORRHAGE; BLOOD transfusion
- Publication
European Archives of Oto-Rhino-Laryngology, 2019, Vol 276, Issue 1, p249
- ISSN
0937-4477
- Publication type
Article
- DOI
10.1007/s00405-018-5192-0