Efficacy and safety of tranexamic acid on blood loss and seizures in patients undergoing meningioma resection: A systematic review and meta-analysis

TL;DR

This study finds that tranexamic acid reduces blood loss during meningioma surgery without increasing seizures or other complications.

Contribution

A systematic review and meta-analysis evaluating the efficacy and safety of tranexamic acid in meningioma resection.

Findings

TXA reduced mean blood loss by 252 mL during meningioma resections.

TXA did not increase postoperative seizure risk or other complication rates.

High heterogeneity was observed in blood loss outcomes (I2 of 94%).

Abstract

It is unclear how tranexamic acid (TXA) affects blood loss and seizures in meningioma resections. We performed a systematic review and meta-analysis and tried to evaluate the effectiveness and safety of TXA use for patients undergoing meningioma resections.

Regards to this systematic review and meta-analysis (registered with CRD42023416693), we searched PubMed, Embase (Ovid), EBSCO, and Cochrane central library up to and including Oct 2023. Patients undergoing meningioma resections treated with TXA and placebo or no treatment were eligible for this study. This would allow delineation of the impact of TXA on blood loss, postoperative seizure, and other complication incidences.

Four prospective cohort studies with 781 patients (390 patients in the TXA group and 391 patients in the control group) were conducted via a systematic review and meta-analysis. The results suggested that the application of TXA for patients undergoing meningioma resections reduced mean blood loss of 252 mL with 95% confidence interval (CI) -469.26 to -34.67 (P = 0.02) and I2 of 94% but did not increase postoperative seizure (risk ratio: 1.08; 95%CI: 0.54 to 2.15; P = 0.84) and other complication rates.

This systematic review and meta-analysis suggests that the administration of TXA could reduce blood loss in patients undergoing intracerebral meningioma resection.

The systematic review protocol has been registered at PROSPERO (Registration No. CRD42023416693) on April 23, 2023.

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