National trends in tranexamic acid use in the peripartum period, 2015-2019.
National trends in tranexamic acid use in the peripartum period, 2015-2019.
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DOI：
10.1007/s11239-020-02141-4
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发表时间：
2020-10
影响因子：
4
通讯作者：
Luban NLC
中科院分区：
文献类型：
--
作者：
Ahmadzia HK;Hynds EB;Amdur RL;Gimovsky AC;James AH;Luban NLC
衡量美国分娩期间氨甲环酸(TXA)的使用趋势，并评估这些患者的人口学数据和发病率结果。这项回溯性队列研究包括来自全民健康服务网络中19家医院的数据。我们比较了2015年1月和2019年6月各地理部门的TXA使用率。我们还评估了接受TXA治疗的妇女的人口统计变量和围产儿结局之间的关系。通过对101,564次分娩的分析，发现209例使用TXA。TXA的使用率随着时间的推移而增加，西部的使用率高于中部和东部；多年来增加的斜率在不同地区没有不同。接受血栓素A治疗的妇女更有可能有产后出血史(59人(28.2%)对2290人(2.2%)，P<；0.0001)，但并不更有可能患有慢性疾病，包括糖尿病、高血压和心脏病。接受血栓素A治疗的女性估计失血量大于或等于1000ml的可能性更大(调整后的优势比为15.3%，95%可信区间为11.1-21.1%；P<；0.0001)。接受TXA治疗的患者发生静脉血栓栓塞症的可能性没有显著增加(AOR 2.0；95%可信区间0.3~14.6；P=0.49)。观察到围产期TXA使用量在全国范围内的增加趋势，不同地理区域有不同的增加。在接受TXA治疗的女性中，静脉血栓栓塞症的可能性并没有显著增加。全国范围内TXA使用量的增加表明，国家产科组织更新的出血指南可以塑造临床实践。
To measure trends in the use of tranexamic acid (TXA) during delivery in the United States and to evaluate demographic data and morbidity outcomes among these patients. This retrospective cohort study includes data from 19 hospitals in the Universal Health Services network. We compared rates of TXA use between January 2015 and June 2019 across geographic sectors. We also evaluated associations of demographic variables and perinatal outcomes of women who received TXA. 209 cases of TXA use were found from analysis of 101,564 deliveries. TXA use increased over time and rates were higher in the West than in Central and East; the slope of increase over years did not differ between regions. Women who received TXA were more likely to have a history of postpartum hemorrhage (59 (28.2%) vs. 2,290 (2.2%), P<0.0001) but were not more likely to have a chronic disease, including diabetes mellitus, hypertension and heart disease. Women who received TXA were more likely to have estimated blood loss greater than or equal to 1000 mL (adjusted odds ratio (aOR) 15.3; 95% CI 11.1—21.1; P<0.0001). Likelihood of venous thromboembolism was not significantly increased in TXA recipients (aOR 2.0; 95% CI 0.3—14.6; P=0.49). Increasing national trends of TXA use in the peripartum period was observed, with variable increases by geographic region. Likelihood of venous thromboembolism was not significantly increased among women who received TXA. Increasing TXA use throughout the country suggests that updated hemorrhage guidelines from national obstetrical organizations can shape clinical practice.
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DOI：
10.1016/s0140-6736(17)30638-4
发表时间：
2017-05-27
期刊：
Lancet (London, England)
影响因子：
--
作者：
WOMAN Trial Collaborators
通讯作者：
WOMAN Trial Collaborators
影响因子：
34.3
作者：
Say, Lale;Chou, Doris;Alkema, Leontine
通讯作者：
Alkema, Leontine
影响因子：
9.8
作者：
Friedman, Alexander M.;Ananth, Cande V.;Huang, Yongmei;D'Alton, Mary E.;Wright, Jason D.
通讯作者：
Wright, Jason D.
影响因子：
6.2
作者：
Ahmadzia, Homa K.;Phillips, Jaclyn M.;James, Andra H.
通讯作者：
James, Andra H.
影响因子：
2.9
作者：
Abdul-Kadir, Rezan;McLintock, Claire;Winikoff, Rochelle
通讯作者：
Winikoff, Rochelle