Hemodynamics, fluids & transfusion
Safety and Efficacy of Tranexamic Acid in General Surgery
Primary result · Primary efficacy outcome (composite bleeding), general surgeryResult — go to the resultHazard ratio 0.74 95% CI 0.59–0.93Authors' conclusion
In this study, TXA significantly reduced the risk of perioperative bleeding without increasing cardiovascular risk in patients undergoing general surgery procedures.
Study context
- Population
- Patients ≥45 years undergoing general surgery (noncardiac) with increased cardiovascular risk, expected at least overnight admissionof 9535 POISE-3 participants
- Participants
- 3,260 patients
- Comparison
- Tranexamic acid (TXA) vs placebo in general surgery
- Primary endpoint
- Composite of:
- Life-threatening bleeding
- Major bleeding
- Bleeding into a critical organ
Methodological detailssubgroup analysis, blinded, international, multicentre, Enrolled June 2018 through July 2021
- Subgroup analysis
- Blinded
- International
- Multicentre
- Enrolled June 2018 through July 2021
Primary result
As reported in the abstract
Primary efficacy outcome (composite bleeding), general surgery
Hazard ratio
0.74
95% CI 0.59–0.93
P = 0.01
By group
TXA vs Placebo
HR 0.74 (95% CI 0.59–0.93); P = 0.01
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Composite bleeding, hepatopancreaticobiliary surgery (subgroup)n = 332 | 0.55 (0.34–0.91) | |
| Composite bleeding, colorectal surgery (subgroup)n = 940 | 0.67 (0.45–0.98) | |
| 0.20.5125Hazard ratio (log scale) |
- Composite bleeding, colorectal surgery (subgroup): no significant interaction across subtypes of general surgery (P for interaction = .68)
Safety
| Outcome | TXA | Placebo | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Primary safety outcome (MINS, nonhemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal VTE), general surgery · 30 days | 11.9% | 12.5% | 0.95 (0.78–1.16) | P = 0.63 | |
| 0.512Hazard ratio (log scale) |
- Primary safety outcome (MINS, nonhemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal VTE), general surgery: no significant interaction by type of surgery (P for interaction = .37)
Original publication
Safety and Efficacy of Tranexamic Acid in General Surgery. JAMA Surg. Published 1 March 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →