title: Safety of Tranexamic Acid in Pediatric Cardiac Surgery: A Nationwide Database Study.
abstract: OBJECTIVE
  The present study aimed to examine the association between tranexamic acid (TXA) use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric cardiac surgery population using a national inpatient database in Japan. The authors also assessed the association between TXA use and other clinical outcomes (length of hospital stay and in-hospital mortality).
  
  
  METHODS
  A nationwide, retrospective cohort study using propensity score analyses.
  
  
  METHODS
  Japanese Diagnosis Procedure Combination inpatient database.
  
  
  METHODS
  Pediatric patients who underwent cardiac surgery using cardiopulmonary bypass between July 2010 and March 2014 (N = 11,275).
  
  
  METHODS
  None.
  
  
  RESULTS
  Propensity-score matching created 3,739 pairs of patients with and without TXA administration. Propensity-matched analysis showed that the proportion of seizures was significantly higher in the TXA group than in the non-TXA group (1.6% v 0.2%, difference, 1.4%; 95% confidence interval, 1.0-1.9; p<0.001). However, none of the other outcomes was significantly different between the groups.
  
  
  CONCLUSIONS
  TXA use is associated with a significantly increased risk of seizures. However, there is no difference in any other outcomes between the TXA and non-TXA groups.
authors.affiliation: Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan; Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: takuma@ncvc.go.jp.
authors.forename: Takuma
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Health Services Research, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sasabuchi
authors.affiliation: Department of Clinical Epidemiology and Health Economics School of Public Health, University of Tokyo, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ohnishi
authors.affiliation: Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Miyata
authors.affiliation: Department of Clinical Epidemiology and Health Economics School of Public Health, University of Tokyo, Tokyo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
mesh_terms: D000933:Antifibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000639:trends; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D057216:Propensity Score; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced* / Q000453:epidemiology; D014148:Tranexamic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: mortality; pediatric cardiac surgery; seizure; tranexamic acid