Delgado LM, Pompeu BF, Martins GH, Azevedo ML, Pasqualotto E, Chulam TC et al.
JAMA Surg 2025; Published online Dec 17, 2025.
Some 26 RCTs including 6,976 patients were studied, demonstrating tranexamic acid (TXA) use was associated with lower intraoperative blood loss (Mean difference −35.85 mL; 95 per cent confidence interval, −57.20 to −14.51 mL, P =0 .001), reduced need for transfusion (Relative risk 0.75, 0.60 to 0.94, P=0 .01, fewer major bleeding events (Relative risk 0.72, 0.59 to 0.89, P=0 .002), without increases in venous thromboembolism, mortality, or length of stay. However, the benefits lost significance in the subgroup analysis specific for abdominal procedures.
Comment: Safety and benefit exist for TXA, but is not a “one-size-fits-all” strategy.
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