| アブストラクト | PURPOSE: Although post-tonsillectomy hemorrhage occurs rarely, it can be life-threatening. Previous studies showed that tranexamic acid (TXA) had insignificant association with the rate of post-tonsillectomy hemorrhage, but those findings were limited by small sample sizes. The purpose of this study was to examine the effectiveness of TXA in preventing post-tonsillectomy hemorrhage using nationwide database. METHODS: Data of a retrospective cohort of 117,598 patients from 750 hospitals, who had undergone tonsillectomy between 2010 and 2016, were drawn from the Diagnosis Procedure Combination database in Japan and studied. RESULTS: Propensity score-matched analysis showed no significant differences in proportions of reoperation or blood transfusion after tonsillectomy between the treatment (TXA from the day of tonsillectomy) and control groups (1.50% vs. 1.47%, p = 0.64). Instrumental variable analysis also showed no significant differences (odds ratio, 0.98; 95% confidence interval, 0.86-1.13; p = 0.82). Higher proportions of reoperation or blood transfusion were significantly associated with male sex, older age, emergency hospitalization, prolonged anesthesia, and medium hospital volume (annual number of tonsillectomies). CONCLUSIONS: Administration of TXA from the day of tonsillectomy is not associated with reduction in reoperation or blood transfusion rates. |
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| ジャーナル名 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
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| 投稿日 | 2018/11/8 |
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| 投稿者 | Koizumi, Megumi; Ishimaru, Miho; Matsui, Hiroki; Fushimi, Kiyohide; Yamasoba, Tatsuya; Yasunaga, Hideo |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 1130033, Japan.;imegumi-zao@umin.ac.jp.;Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The;University of Tokyo, Tokyo, Japan. imegumi-zao@umin.ac.jp.;Department of Health Policy and Informatics, Graduate School of Medicine, Tokyo;Medical and Dental University, Tokyo, Japan.;University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30402793/ |
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