Demographic variables
Twenty-eight patients met the inclusion criteria and were randomly assigned to one of two groups: control, NAT (no tranexamic acid), experimental, or WAT (with tranexamic acid). The mean age in the NAT group was 15.4 years (range, 9–24 years; IQR, 15.5 years), while the mean age in the WAT group was 14.8 years (range, 12–19 years; IQR, 15.0). In terms of age, there was no significant difference between the groups (p = 0.71) (Figure 1).
In terms of sex distribution, 13 patients (92.85%) in both the NAT and WAT groups were female, whereas one patient (7.15%) was male; hence, these two groups were not significantly different (p = 1) (Figure 2).
There was also no statistically significant difference concerning the values of body weight (kg) or BMI when we compared the groups: the mean NAT was 40.9 kg (23-56 kg, IQR 42.5), and the mean WAT was 47.8 kg (22-66 kg, IQR 49.0). Regarding BMI, patients in the NAT groups had values ranging from 9.1 to 17.4 kg, with a mean of 13.6 kg (±2.4 kg), whereas patients in the WAT group had values ranging from 8.5 to 20.3 kg and a mean of 14.9 kg (±3.0 kg) (Figure 03).
There were eight more cases of adolescent idiopathic scoliosis in the NAT group than in the tranexamic acid (WAT) group (Table 01). However, there was no significant difference in the etiology of scoliosis between the groups (p > 0.05).
Surgical Variables
Moreover, there was no significant difference in the number of vertebral levels involved in the fusion surgery between the two groups (p >0.05). (Table 02).
When the preoperative hemoglobin levels (g/dl), total surgical duration (min), and number of transfused blood products (ml) were compared between the groups, there was no statistically significant difference (p >0.05). (Table 03).
Preoperative hemoglobin (Hb) varied from 10.7 g/dl to 14.7 g/dl, with a mean of 13.0 g/dl in the NAT group (IQR of 13), and from 11.1 g/dl to 16.2 g/dl, with an average of 13.3 g/dl in the WAT group (IQR of 13.1). The total operation time (min) for patients in the WAT group was slightly longer, with an average of 220.4 min, than that for patients in the NAT group, which was 182.5 min. However, the results were not statistically significant (P = 0.1028). Finally, comparison of the number of blood products transfused in each group of patients yielded no statistically significant results (p > 0.05).
Postoperative variables
Moreover, there were no statistically significant differences between the NAT and WAT groups in terms of postoperative outcomes, total blood loss (ml), total drain loss (ml), total hospitalization duration (days), or Hb values on the first and third postoperative days (PO1 and PO3, respectively) (Table 04).
The total blood loss in the NAT group ranged from 110 to 1500 ml, with a mean of 840.7 ml. Blood loss in the WAT group ranged from 550 to 1400 ml, with an average of 732.5 ml (p= 0.3988). The total drain loss in the WAT group ranged from 200 to 1250 ml (mean 662.8 ml); however, in the NAT group, the smallest loss was 200 ml, and the maximum loss was 1265 ml, with a mean of 675.3 ml (P = 0.73). (Figure 4 and Table 04). The WAT group had a slightly greater mean Hb concentration on PO1 (mean 9.9 ml) than the NAT group (mean 8.6 ml); however, the difference was not statistically significant (p = 0.23). The mean PO3 values in the two groups were 10.0 ml and 10.5 ml, respectively. (p = 0.37). (Table 04). Similarly, the total hospitalization time (days) was not substantially different across groups, with an average of 7 days for the WAT group and 7 days for the NAT group, both ranging from 4 to 18 days (Table 04).
In terms of complications, there was one case of surgical site infection, one case of bladder infection, one case of dyspnea, and four cases of nausea and vomiting in the tranexamic acid (WAT) group. We found one case of urinary tract infection, two cases of metabolic acidosis, one case of intestinal blockage, and two cases of nausea and vomiting in the NAT group. Based on this information and probable tranexamic acid-related effects (nausea and vomiting), we found no significant difference in the number of complications between the groups that received tranexamic acid (WAT) and those that did not (NAT) (p = 0.32) (Table 05).