Post-operative tranexamic acid decreases chest tube drainage following vertebral body tethering surgery for scoliosis correction

Lily Eaker, Stephen R. Selverian, Laura N. Hodo, Jonathan Gal, Sandeep Gangadharan, James Meyers, Sergei Dolgopolov, Baron Lonner

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: Anterior vertebral body tethering (VBT) is a non-fusion surgical treatment for Adolescent Idiopathic Scoliosis requiring chest tube(s) (CT). We sought to assess the efficacy of post-op intravenous tranexamic acid (IV TXA) in reducing CT drainage and retention. Methods: 35 VBT patients received 24 h of post-op IV TXA (2 mg/kg/h) were compared to 49 who did not. Group comparisons were performed using Wilcoxon rank-sum and chi-squared tests. Multivariate linear regression analysis was used to assess the relationships between TXA and both CT drainage and retention time. Results: There were no group differences at baseline (Table). CTs placed for thoracic (T) and thoracolumbar (TL) curves were assessed separately. For TH CT, there was less total CT drainage in the TXA group (TXA 569.4 ± 337.4 mL vs. Non-TXA 782.5 ± 338.9 mL; p = 0.003) and shorter CT retention time (TXA 3.0 ± 1.3 vs. Non-TXA 3.9 ± 1.4 days; p = 0.003). For TL CT, there was less total CT drainage in the TXA group (TXA 206.8 ± 152.2 mL vs. Non-TXA 395.7 ± 196.1 mL; p = 0.003) and shorter CT retention time (TXA 1.7 ± 1.3 vs. Non-TXA 2.7 ± 1.0 days; p = 0.001). Following multivariate analysis, use of TXA was the only significant predictor of both drainage in T and TL CTs (p = 0.012 and p = 0.002, respectively) as well as T and TL CT retention time (p = 0.008 and p = 0.009, respectively). There were no differences in LOS (p = 0.863) or ICU stay (p = 0.290). Conclusion: IV TXA results in a significant decrease in CT drainage and retention time. CT retention is decreased by 1 day for those that receive TXA. Level of evidence: III.

Original languageEnglish
Pages (from-to)811-816
Number of pages6
JournalSpine Deformity
Volume10
Issue number4
DOIs
StatePublished - Jul 2022

Keywords

  • Chest tube management
  • Tranexamic acid
  • Vertebral body tethering

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