Effect of Tranexamic Acid on Inpatient Admission and Revision Rates in Primary Rhinoplasty: A Propensity...

Area of Science:

• Plastic Surgery
• Anesthesiology
• Otolaryngology

Background:

• Tranexamic acid (TXA) is recognized for reducing bleeding in surgery.
• Its specific benefits in primary rhinoplasty, particularly regarding revision rates and hospital admissions, require further investigation.
• Previous studies suggest TXA may reduce swelling and bruising after rhinoplasty.

Purpose of the Study:

• To evaluate the efficacy of tranexamic acid (TXA) in improving perioperative outcomes for primary rhinoplasty.
• To analyze the impact of TXA on inpatient admission rates, revision surgery, and other postoperative complications.
• To assess the safety profile of TXA in the context of rhinoplasty procedures.

Main Methods:

• Retrospective cohort study utilizing the TriNetX database (133 million US medical records, 20 years).
• Identified patients undergoing primary rhinoplasty, comparing outcomes between TXA and non-TXA groups.
• Propensity score-matching adjusted for demographics, tobacco use, and bleeding-risk comorbidities; analyzed outcomes up to 2 weeks and revision rates within 1 year.

Main Results:

• 1639 TXA and 33,221 non-TXA patients identified; 1627 per group after matching.
• TXA group showed significantly lower inpatient admissions (OR 0.492, P=0.003) and fewer revisions (OR 0.441, P<0.028).
• No significant differences in hemoglobin or ED visits; no reported vascular complications.

Conclusions:

• TXA administration in primary rhinoplasty is associated with reduced inpatient admissions and revision rates.
• While not significantly impacting overall blood loss (hemoglobin), TXA may enhance intraoperative visibility, potentially improving surgical precision.
• TXA demonstrated a favorable safety profile, with no increase in adverse events observed.