The use of intra-operative tranexamic acid in shoulder surgery: Protocol for a systematic review and meta-analysis

International Journal of Surgery Protocols
Alexander W HartlandMustafa S Rashid

Abstract

Blood loss is an important consideration in all types of shoulder surgery. Excessive bleeding is associated with increased morbidity. Tranexamic acid (TXA) is an antifibrinolytic agent. It has been demonstrated to be effective in reducing blood loss across multiple surgical specialties. The aim of this systematic review and meta-analysis is to review the literature evaluating clinical outcomes associated with the use of TXA in shoulder surgery. The study protocol was designed and registered prospectively on PROSPERO (International prospective register for systematic reviews). Literature search will include the MEDLINE, EMBASE, PsycINFO, and Cochrane Library databases. Randomised controlled trials (RCTs) evaluating the use of TXA against placebo, in all types of shoulder surgery, will be included. Our primary outcome is total blood loss (ml). Secondary outcomes include patient-reported outcome measures (PROMs), adverse events, and number of blood transfusions required. Risk of bias will be assessed within each study using The Cochrane Risk of Bias Tool 2.0 and the Jadad score. Inconsistency and bias across included studies will be assessed statistically. Data from comparable outcomes will be pooled and analysed quantitatively or...Continue Reading

References

Feb 1, 1996·Controlled Clinical Trials·A R JadadH J McQuay
Dec 13, 2005·Journal of Shoulder and Elbow Surgery·John W SperlingWilliam S Harmsen
Apr 26, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
Jul 23, 2009·BMJ : British Medical Journal·David MoherUNKNOWN PRISMA Group
Jan 7, 2011·Journal of Clinical Epidemiology·Howard BalshemGordon H Guyatt
Jul 24, 2012·Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen·Gero LangerHolger Schünemann
Feb 6, 2017·Journal of Shoulder and Elbow Surgery·A Jordan GrierGrant E Garrigues
Apr 23, 2017·Wiener klinische Wochenschrift·Ingrid PabingerWolfgang Toller
Sep 8, 2017·Acta Orthopaedica·Anne LübbekeAlan J Silman
Dec 12, 2017·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Rachel M FrankAnthony A Romeo

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