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BMJ 2012;344:e3054 doi: 10.1136/bmj.e3054 (Published 20 May 2012)
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Research
RESEARCH Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis OPEN ACCESS
Katharine Ker research fellow, Phil Edwards senior lecturer, Pablo Perel clinical senior lecturer, Haleema Shakur senior lecturer, Ian Roberts professor of epidemiology Clinical Trials Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Abstract Objective To assess the effect of tranexamic acid on blood transfusion, thromboembolic events, and mortality in surgical patients. Design Systematic review and meta-analysis. Data sources Cochrane central register of controlled trials, Medline, and Embase, from inception to September 2011, the World Health Organization International Clinical Trials Registry Platform, and the reference lists of relevant articles. Study selection Randomised controlled trials comparing tranexamic acid with no tranexamic acid or placebo in surgical patients. Outcome measures of interest were the number of patients receiving a blood transfusion; the number of patients with a thromboembolic event (myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism); and the number of deaths. Trials were included irrespective of language or publication status. Results 129 trials, totalling 10 488 patients, carried out between 1972 and 2011 were included. Tranexamic acid reduced the probability of receiving a blood transfusion by a third (risk ratio 0.62, 95% confidence interval 0.58 to 0.65; P
