Haemodynamics, fluids & transfusion
Perioperative Use of Tranexamic Acid in General Surgery: A Systematic Review and Meta-Analysis
Authors' conclusion
This systematic review and meta-analysis found that prophylactic TXA use was associated with lower intraoperative blood loss, transfusion requirements, and major bleeding without an observed increase in thromboembolic or mortality risk.
Study context
- Population
- Adults undergoing general surgery
- Participants
- 6,976 adults · 26 randomized clinical trials (RCTs)
- Comparison
- Prophylactic tranexamic acid (TXA) vs placebo
- Outcome
- Intraoperative blood loss, need for transfusion, and major bleeding
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
TXA vs PlaceboMD, mL (95% CI)P value
Intraoperative blood loss; I2 = 91%
−35.85(−57.20 to −14.51)
P = 0.001TXA vs PlaceboRelative risk (95% CI)P value
Need for transfusion; I2 = 54%
0.75(0.60–0.94)
P = 0.01Major bleeding; I2 = 0%
0.72(0.59–0.89)
P = 0.002Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding, hepatobiliary procedures (subgroup)I2 = 0% | 0.59 (0.39–0.90) | P = 0.01 | |
| 0.20.5125Relative risk (log scale) |
Length of stay
- No significant difference
Intraoperative blood loss and need for transfusion, abdominal procedures (subgroup)
- Benefits observed in the overall population no longer present
Major bleeding, hepatobiliary procedures (subgroup)
- No significant differences for the other outcomes in the hepatobiliary subgroup
Mortality
- No significant difference
Safety
Venous thromboembolism
- No significant difference
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Perioperative Use of Tranexamic Acid in General Surgery: A Systematic Review and Meta-Analysis. JAMA Surg. Published 1 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →