Therapeutics and Clinical Risk Management最新文献

{"title":"Establishment and Verification of Risk Prediction Model for Adverse Outcomes After Hip Arthroplasty in Elderly Patients.","authors":"Jie Ding, Guoli Sun, Yifei Ren, Jiajia Xu, Qingqing Hu, Jun Luo, Zhaowen Wu, Ting Chu","doi":"10.2147/TCRM.S523040","DOIUrl":"https://doi.org/10.2147/TCRM.S523040","url":null,"abstract":"<p><strong>Background: </strong>Adverse outcomes after hip arthroplasty in elderly patients are frequently observed; however, most existing studies concentrate on single complications. Comprehensive predictive models for a wider range of adverse outcomes remain insufficient. This study explores this issue and proposes new approaches for clinical practice.</p><p><strong>Purpose: </strong>This study aimed to construct and verify risk prediction model for adverse outcomes after hip arthroplasty in elderly patients.</p><p><strong>Patients and methods: </strong>The TRIPOD checklist was followed to guide the reporting of this study. Data from 620 subjects who underwent hip arthroplasty at a tertiary A-level hospital from January 1, 2021 to December 31, 2023 were used for the modelling group. Additionally, 264 post-hip arthroplasty patients admitted to the orthopaedic department of another tertiary A-level hospital from January 1, 2024 to December 31, 2024 were selected as the validation group. Risk prediction models were constructed by logistic regression, plotted in column line graphs and evaluated for their predictive effectiveness.</p><p><strong>Results: </strong>The factors included in the prediction model were age, malignancy history, surgical procedure, albumin, prothrombin time, ASA grade, operation duration, and changeover surgery status. Hosmer-Lemeshow test, <i>χ2</i>=5.418, <i>p</i>=0.712, the area under the receiver operating characteristic curve (AUC) was 0.902. The Youden index is 0.668, with a sensitivity of 0.84 and a specificity of 0.828. The correct practical application rate was 83.33%.</p><p><strong>Conclusion: </strong>The risk prediction model constructed in this study demonstrates favourable predictive performance and can serve as a reference for healthcare professionals in predicting the risk of adverse outcomes after hip arthroplasty in elderly patients.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1047-1058"},"PeriodicalIF":2.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Impact of Hypertension and Antihypertensive Treatment on COVID-19 Severity: A Retrospective Observational Study in Ternopil Region, Ukraine [Corrigendum].","authors":"","doi":"10.2147/TCRM.S551276","DOIUrl":"https://doi.org/10.2147/TCRM.S551276","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/TCRM.S527151.].</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1045-1046"},"PeriodicalIF":2.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment in Stroke Patients of Working Age: A Multicenter Observational Study of Real-World Outcomes.","authors":"Yongting Zhou, Mohammad Mofatteh, Zijie Zheng, Feng Liu, Sijie Zhou, Jicai Ma, Zile Yan, Yuzheng Lai, Weijiang Li, Weiying Chen, Mohamad Abdalkader, Robert W Regenhardt, Xiangmin Liu","doi":"10.2147/TCRM.S508295","DOIUrl":"10.2147/TCRM.S508295","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of acute ischemic stroke (AIS) is increasing among people of working age, posing socioeconomic and healthcare challenges. Inability to return to work can have significant negative consequences and contribute to the economic burden of stroke. Endovascular treatment (EVT) has been established as the standard of care for large vessel occlusion AIS patients. In this study, we aimed to identify factors predicting favorable outcome among working age AIS patients undergoing EVT.</p><p><strong>Patients and methods: </strong>We analyzed data from 309 patients from five comprehensive stroke centers between 2019 and 2023. All patients were working age (18<59) with symptoms onset of within 24 hours. Modified thrombolysis in cerebral infarction (mTICI) score of 2b-3 was considered as successful recanalization. We used 3-months mRS post-EVT to evaluate the outcome; mRS of 0-2 was defined as favorable outcome, whereas mRS of 3-6 was considered unfavorable outcome.</p><p><strong>Results: </strong>The unfavorable outcome group consisted of 150 patients, and 159 patients were in the favorable outcome group. More people in the unfavorable outcome group had diabetes (29.33% vs 15.72%, p=0.004) and hypertension (61.33% vs 40.88, p<0.001). A multivariable regression analysis demonstrated that several factors, including successful recanalization (odds ratio (OR) 5.298, 95% confidence interval (CI) 1.735-16.174, p=0.003), pre-EVT NIHSS (OR 0.892, 95% CI 0.852-0.934, p=0.000), baseline Alberta stroke program early CT score (ASPECTS) (OR 1.609, 95% CI 1.274-2.032, p=0.000), hypertension (OR 0.477, 95% CI 0.270-0.845, p=0.011), diabetes mellitus (OR 0.413, 95% CI 0.208-0.820, p=0.011), and symptomatic intracerebral hemorrhage (sICH) (OR 0.045, 95% CI 0.006-0.359, p=0.003) can predict the outcome of patients undergoing EVT.</p><p><strong>Conclusion: </strong>Favorable outcome of working age patients with AIS undergoing EVT can be predicted using multiple factors, including hypertension, diabetes mellitus, successful recanalization, pre-EVT NIHSS, baseline ASPECTS, and sICH.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1009-1019"},"PeriodicalIF":2.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Minimal-Dose S-Ketamine Administration Post-Surgery on Opioids Consumption and Functional Rehabilitation Exercises in Patients Undergoing Minimally Invasive Radical Resection of Esophageal Cancer.","authors":"Jue Xie, Fangming Shen, Xingming Wang, Juan Yao, Lingzhen Zhou, Luxin Huang, Jie Sun","doi":"10.2147/TCRM.S527262","DOIUrl":"10.2147/TCRM.S527262","url":null,"abstract":"<p><strong>Study objective: </strong>To examine the impact of minimal-dose S-ketamine on postoperative analgesia in patients undergoing minimally invasive radical resection for esophageal cancer, with a focus on reducing opioid consumption, enhancing analgesic quality, and facilitating postoperative recovery.</p><p><strong>Methods: </strong>A total of 216 patients undergoing minimally invasive radical resection of esophageal cancer under general anesthesia were randomly assigned into two groups (S-ketamine and control group), receiving intravenous S-ketamine (0.015 mg/kg/h) or an equal volume of saline for 48 h postoperatively. The primary outcome was cumulative oxycodone consumption in the first 48 h postoperatively. Secondary outcomes included functional activity score (FAS) after one bolus administration, numerical rating scale (NRS) pain scores at rest and when coughing, cumulative oxycodone consumption in different time periods, incidence of postoperative nausea and vomiting (PONV), level of sedation (LOS) score, time to first postoperative flatulence, postoperative delirium, activities of daily living assessed by BI (Barthel Index) and so on.</p><p><strong>Main results: </strong>The postoperative opioid consumption within 48 hours in S-ketamine group was significantly lower than those in placebo group (<i>P</i> < 0.001), and the difference between the two groups was 40% (mean: 44.5 mg vs 74.8 mg). FAS after one bolus administration and BI in the S-ketamine group were notably superior to those in the control group (<i>P</i> < 0.001). There were Statistical differences between the two groups in the NRS scores at rest at postoperative hour 48 (<i>P</i> = 0.001) and the NRS scores when coughing at postoperative hour 12 (<i>P</i> = 0.011) with mean differences of -0.3 and 0.4, respectively.</p><p><strong>Conclusion: </strong>Minimal-dose S-ketamine for managing acute postoperative pain in patients undergoing radical resection for esophageal cancer led to a 40% reduction in opioid consumption and promoted rehabilitation.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1033-1044"},"PeriodicalIF":2.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Spontaneous Potential in Left Atrial Posterior Wall Isolation and Radiofrequency Ablation for Non-Paroxysmal Atrial Fibrillation.","authors":"Zhi-Yang Chen, Yu-Hong Zhong, Ke-Zeng Gong, Xue-Hai Chen, Zhe Xu, Fei-Long Zhang","doi":"10.2147/TCRM.S525135","DOIUrl":"10.2147/TCRM.S525135","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the long-term effects of left atrial posterior wall spontaneous potential (SP) in patients with non-paroxysmal atrial fibrillation (AF) who underwent pulmonary vein isolation (PVI) combined with left atrial posterior wall isolation (PVI+BOX) ablation.</p><p><strong>Methods: </strong>Clinical data were retrospectively collected from 140 patients with symptomatic non-paroxysmal atrial fibrillation (NPAF) who underwent first-time radiofrequency ablation between 2022 and 2023. Based on the surgical procedure, patients were categorized into the pulmonary vein isolation group (PVI group) and the pulmonary vein isolation + left atrial posterior wall isolation group (PVI+BOX group). The PVI+BOX group was further subdivided into the spontaneous potential group (SP group) and the no-spontaneous potential group (no-SP group) based on the presence of SP after left atrial posterior wall isolation. Patients underwent monthly follow-ups in the clinic or via telephone and received 72-hour dynamic electrocardiography (ECG) at 3 and 12 months postoperatively. AF recurrence was compared among the groups, and factors associated with recurrence following AF ablation were analyzed.</p><p><strong>Results: </strong>The PVI+BOX group included 78 cases, with 45 in the no-SP group and 33 in the SP group, while the PVI group comprised 62 cases. No significant difference was observed in the postoperative recurrence-free rate between the PVI+BOX and PVI groups. However, the SP group exhibited a higher postoperative recurrence-free rate compared to both the no-SP group (<i>p</i> = 0.039) and the PVI group (<i>p</i> = 0.020). No significant difference was found in the late recurrence-free rate between the no-SP and PVI groups. Multivariate logistic regression analysis indicated that the duration of AF and the presence of left atrial posterior wall SP were independent risk factors for post-ablation recurrence in patients with NPAF.</p><p><strong>Conclusion: </strong>The presence of SP post-left atrial posterior wall isolation suggests a better long-term outcome in patients with NPAF following PVI+BOX catheter ablation.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1021-1031"},"PeriodicalIF":2.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Impact of Intravenous Iron Sucrose and Ferric Carboxymaltose on Hypophosphatemia and Anemia Parameters in Iron Deficiency Anemia: A Retrospective Study.","authors":"Sefer Aslan, Serhat Doğan, Mehmet Sarıaydın, Aşkı Vural, Ersin Kuloglu, Ali Muhtaroğlu","doi":"10.2147/TCRM.S529064","DOIUrl":"10.2147/TCRM.S529064","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to determine the incidence of hypophosphatemia and evaluate anemia parameters following intravenous iron sucrose (IS) and iron carboxymaltose (FCM) therapy in patients diagnosed with iron deficiency anemia (IDA).</p><p><strong>Methods: </strong>This retrospective study included 108 patients aged 18-67 who were diagnosed with IDA and received either FCM or IS therapy. The patients were divided into two groups: iron sucrose (n=55, 51%) and ferric carboxymaltose (n=53, 49%). We collected and analysed data on patient demographics, doses of FCM and IS, and laboratory parameters including serum phosphorus, ferritin, total iron-binding capacity (TIBC), iron, and haemoglobin (Hg) values.</p><p><strong>Results: </strong>The pre-treatment blood phosphorus levels were significantly lower in the IS group than in the FCM group (p = 0.029). Following intravenous iron treatment, the TIBC and phosphorus levels were higher in the IS group compared to the FCM group (p = 0.011 and p <0.001, respectively). The ferritin levels were significantly higher in the FCM group compared to the IS group (p = 0.002).</p><p><strong>Conclusion: </strong>It is important to be aware that hypophosphatemia may occur after intravenous iron therapy for iron deficiency anemia. Therefore, phosphate levels should be monitored closely following treatment. Furthermore, it would appear that hypophosphatemia is more prevalent following FCM therapy compared to IS.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"987-993"},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Higher Incidence of Liver Injury in HCC Patients Compared to Other Malignancies During Immune-Checkpoint Inhibitor Therapy is Primarily Due to Tumor Progression.","authors":"Yan Wang, Liwei Liu, Mengyu Zhao, Wei Chen, Yu Chen, Xinyan Zhao","doi":"10.2147/TCRM.S514868","DOIUrl":"10.2147/TCRM.S514868","url":null,"abstract":"<p><strong>Background: </strong>The study explores the incidence and clinical features of immune-related liver injury (irLI) in hepatocellular carcinoma (HCC) patients compared to those with other malignancies receiving immune checkpoint inhibitors (ICIs).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients treated with ICIs at Beijing Friendship Hospital. Individuals who experienced liver injury consistent with the criteria specified in the Common Terminology Criteria for Advanced Event version 5.0 for irLI were included in the study. The cohort was divided into an HCC group and a non-HCC malignancy group. HCC patients were further classified into three subgroups based on liver injury: no injury, irLI, or non-immune-related liver injury. Data on demographics, laboratory results, and mortality rates were compared.</p><p><strong>Results: </strong>The study included 292 hCC patients and 1248 patients with other malignancies. Both groups underwent a similar number of ICIs cycles (p=0.237). Liver injury was more common in HCC patients [98 (33.6%) vs 288 (23.1%), p<0.001], but the irLI incidence was comparable between the groups [17 (5.8%) vs 62 (5.0%), p=0.556]. Tumor progression-related liver injury was higher in HCC patients (12.0%) compared to other malignancies (4.6%). Mortality rates showed no significant differences between groups.</p><p><strong>Conclusion: </strong>HCC patients with underlying liver disease are more prone to liver injury during ICIs therapy, mainly due to tumor progression rather than irLI.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"963-974"},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hypertension and Antihypertensive Treatment on COVID-19 Severity: A Retrospective Observational Study in Ternopil Region, Ukraine.","authors":"Marian Hrebenyk, Sofia Maslii, Oksana Shevchuk, Roman Komorovsky, Mykhaylo Korda","doi":"10.2147/TCRM.S527151","DOIUrl":"10.2147/TCRM.S527151","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HP) may significantly affect the prognosis of COVID-19 illness. Understanding the epidemiological and clinical characteristics of post-COVID-19 patients with HP and other comorbidities is important for improving outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective observational study in the Ternopil region of Ukraine involving 926 subjects: 848 individuals in the post-COVID period (0-90 days after a negative SARS-CoV-2 PCR test) and 78 (8.4%) in a control group. Data on medical history, clinical manifestations, treatment modalities, and pathomorphological findings were collected. Patients were categorized into four groups based on COVID-19 severity: mild, moderate, severe, and critical.</p><p><strong>Results: </strong>HP was present in 46.2% of patients, with a prevalence of 75.0% among fatal cases (p<0.001). Diabetes mellitus (DM) was diagnosed in 17.6%. HP was not associated with increased susceptibility to SARS-CoV-2 infection. In-hospital mortality risk significantly correlated with age (r=0.306, p<0.001), HP (r=0.145, p=0.001), DM (r=0.144, p=0.001), combined HP and DM (r=0.159, p<0.001), and irregular antihypertensive treatment (r=-0.118, p=0.037). However, regular use of ACE inhibitors or ARBs did not significantly affect prognosis. Multivariable logistic regression identified age and irregular antihypertensive treatment as independent predictors of in-hospital mortality.</p><p><strong>Conclusion: </strong>HP was not associated with increased susceptibility to SARS-CoV-2 infection, based on similar prevalence rates in patients and controls, but was linked to worse outcomes when combined with other risk factors. Age and irregular antihypertensive treatment emerged as independent predictors of in-hospital mortality. These findings highlight the importance of regular blood pressure management in reducing the severity and improving the prognosis of COVID-19 in hypertensive patients.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"995-1007"},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Organoid Models as Pivotal Tools for Unraveling Molecular Mechanisms and Therapeutic Targets in Respiratory Diseases: A Literature Review.","authors":"Shu-Ping Jiang, Bing-Qi Lin, Xing-Qiang Zhou, Min-Hua Li, Zhen-Cheng Feng, Yue-Ying Qin, Shi-Qi Lin, Zi-Qing Zhou, Yang Peng, Lian Li","doi":"10.2147/TCRM.S526727","DOIUrl":"10.2147/TCRM.S526727","url":null,"abstract":"<p><p>Respiratory inflammatory and infectious diseases continue to impose a substantial global health burden, compounded by persistent gaps in understanding their pathogenic mechanisms and limited therapeutic advancements. To address these challenges, this review systematically analyzed literature from PubMed, Web of Science, and Scopus databases (2005-2025) to evaluate the evolution and applications of airway organoid models in respiratory disease research. Key findings include: (1) the convergence of traditional culture techniques with advanced methodologies - including 3D matrix embedding, bioprinting and organoids-on-chips technologies - has enabled unprecedented recapitulation of human airway architecture and multicellular interactions; (2) these novel models provide unique insights into disease pathogenesis, host-microbe dynamics, and drug response variability; (3) the inherent capacity to maintain native cellular diversity and disease-associated phenotypes positions airway organoids as crucial platforms for personalized medicine approaches. Collectively, these advances establish airway organoids as transformative tools that bridge conventional in vitro models and clinical reality. Looking ahead, coupling organs-on-chips platforms with microgravity culture and single-cell lineage tracing will catalyze fundamental breakthroughs in respiratory disease research.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"975-986"},"PeriodicalIF":2.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic Acid Demonstrated a Trend Toward Decreased Perioperative Blood Loss in Posterior Decompression Surgery of Patient with Metastatic Spinal Tumor.","authors":"Yunpeng Cui, Huaijin Li, Chuan Mi, Bing Wang, Yuanxing Pan, Wei Yu, Xuedong Shi","doi":"10.2147/TCRM.S516261","DOIUrl":"10.2147/TCRM.S516261","url":null,"abstract":"<p><strong>Background: </strong>To explore the effect of tranexamic acid (TXA) on perioperative blood loss in posterior decompression surgery of patient with metastatic spinal tumor.</p><p><strong>Methods: </strong>Three hundred sixty-eight consecutive patients between May 2011 and Aug 2022 were retrospectively reviewed. One hundred eighty patients (182 surgeries) met the criteria and were included in the study. Sixty-two surgeries received preoperative intravenous TXA (TXA group), and 120 did not (non-TXA group). The primary outcome was total blood loss. <i>T</i>-test, Mann-Whitney U, and chi-square tests were used to evaluate the difference in baseline data, total blood loss, and other outcome measures between the two groups.</p><p><strong>Results: </strong>Patients with hyper vascular tumors had significantly more blood loss compared with non-hyper vascular tumors (2002(1531,2792) mL vs 1469(1036,1962) mL, p=0.001). There was no significant different in the postoperative venous thromboembolism of the lower limb between the two groups. For patients with non-hyper vascular tumors, the blood loss (1216(827, 1709) mL vs 1561(1146, 2019) mL, p = 0.012) and postoperative drainage (1-day post-operation: 240(150,290) mL vs 280(150,395) mL, p=0.040; 3-days post-operation: 450(348,630) mL vs 613(398,799) mL, p=0.025) of TXA group were significantly less compared with that of the non-TXA group. Meanwhile, the TXA group had significantly less postoperative hospitalization compared with the non-TXA group (11.0(9.0, 13.3) days vs 12.5(9.0, 16.3) days, p=0.023). For patients with hyper vascular tumors, there were no significant differences in the blood loss and amount of postoperative drainage between the two groups.</p><p><strong>Conclusion: </strong>Preoperative intravenous TXA demonstrated a trend toward decreased perioperative blood loss in posterior decompression surgery of spinal metastases with non-hyper vascular tumors.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"951-962"},"PeriodicalIF":2.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}