Tranexamic acid reduces intraoperative red blood cell transfusion rates in craniosynostosis surgery: a 6-year retrospective analysis

Figures & data

Figure 1. Distribution of craniosynostoses according to the affected suture. S: scaphocephaly; T: trigonocephaly; P: plagiocephaly; BC: bicoronal fusion; S + T: complex disorder of sagittal and metopic fusion.

Table 1. Demographic data and characteristics of patients who underwent craniosynostosis surgery.

Variable	Non-TXA	TXA	p-value
Number of patients/number of procedures	36/53	44/60
Age (months)	5.7 ± 4	5.5 ± 3.8	0.771
Weight (kg)	6.9 ± 2	6.7 ± 1.6	0.35
Male/female ratio	33/20	38/22	0.907
Duration of surgery (minutes)	94 ± 20	98 ± 25	0.308
Postoperative length of stay (days)	4.3 ± 0.8	4.3 ± 0.8	0.73
Preoperative hemoglobin (g/dL)	115.9 ± 10.7	112 ± 11.7	0.205
Preoperative hematocrit	0.33 ± 0.04	0.33 ± 0.04	0.905

Table 2. Intraoperative and postoperative PRBC transfusions in patients with and without TXA.

Variable	Non-TXA	TXA	p-value
Intraoperative period
Frequency of PRBC transfusion (number of procedures with transfusion/%)	44/83%	16/26.7%	<0.001
Volume (mL)	101.9 ± 26.6	68.25 ± 20.2	<0.001
Weight-adjusted volume (mL/kg)	15.1 ± 4.4	11.2 ± 2.2	0.002
Postoperative period
Frequency of PRBC transfusion (number of procedures with transfusion/%)	5/9.4%	7/11.7%	0.701
Volume (mL)	84.6 ± 32.3	68 ± 18.6	0.342
Weight-adjusted volume (mL/kg)	13.5 ± 5.8	10.8 ± 3.2	0.375

Table 3. PRBC transfusions in relation to the affected suture and type of operation.

Type of craniosynostosis and intervention	Intraoperative PRBC transfusions (number of procedures with transfusion/%)			Postoperative PRBC transfusions (number of procedures with transfusion/%)
	Non-TXA	TXA	p-value	Non-TXA	TXA	p-value
P	2/67%	2/33%	0.343	0/0%	0/0%	–
S1	16/84.2%	7/38.9%	0.004	2/10.5%	2/11%	0.954
S2	15/83.3%	3/15.8%	0.001	3/16.7%	5/26.3%	0.476
T	9/82%	4/23.5%	0.008	0/0%	0/0%	–

P: plagiocephaly; S1: 1st stage operation for sagittal craniosynostosis; S2: 2nd stage operation for sagittal craniosynostosis; T: trigonocephaly.

Table 4. Intraoperative and postoperative PRBC transfusions in patients without TXA.

Variable	Pre- TXA	Post-TXA	p-value
Intraoperative period
Frequency of PRBC transfusion (number of procedures with transfusion/%)	31/100%	13/59.1%	<0.001
Volume (mL)	113 ± 18.6	75.5 ± 24.8	<0.001
Weight-adjusted volume (mL/kg)	16.2 ± 4.3	12.4 ± 3.3	0.007
Postoperative period
Frequency of PRBC transfusion (number of procedures with transfusion/%)	2/6.5%	3/13.6%	0.378
Volume (mL)	120 ± 0	61 ± 1.7	<0.001
Weight-adjusted volume (mL/kg)	19.7 ± 1.8	9.4 ± 1.4	<0.001

Pre-TXA: the period before TXA introduction in practice; post-TXA: the period after TXA introduction in practice.

Data availability statement

The data that support the findings of this study are available from the corresponding author, RT, upon reasonable request.