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Table 3 Summary of findings of shoulder arthroplasty

From: Tranexamic acid in total shoulder arthroplasty and reverse shoulder arthroplasty: a systematic review and meta-analysis

Outcomes N Patients (TXA/non-TXA) Overall effect Heterogeneity
RR or MD (95% CI) P I2 P
Rate of blood transfusion
 All included studies 5 319/313 0.34 [0.14, 0.79] 0.02 0% 0.42
 Randomized controlled trials 3 136/131 0.23 [0.07, 0.77] 0.01 NA NA
 RTSA 4 141/150 0.28 [0.10, 0.83] 0.02 0% 0.47
Estimated total blood loss (ml)
 All included studies 3 157/170 -249.24 [−338.74, −159.74] <  0.00001 20% 0.29
 Randomized controlled trials 2 80/76 − 357.92 [− 504.25, −211.59] <  0.00001 0% 0.87
 RTSA 2 95/101 −249.15 [−426.60, −71.70] 0.006 64% 0.10
Hb change within 48 h after surgery (g/dl)a
 All included studies 5 316/310 −0.64 [− 0.81, − 0.46] 0.009 0% 0.72
 Randomized controlled trials 2 109/104 −0.65 [− 1.14, − 0.16] <  0.00001 42% 0.19
 RTSA 4 153/158 −0.64 [− 0.86, − 0.42] <  0.0001 0% 0.66
 IV TXA 5 260/255 −0.60 [− 0.79, − 0.41] <  0.0001 0% 0.79
 Topical TXA 1 56/55 −0.90 [− 1.42, − 0.38] 0.0007 NA NA
Blood loss via drainage within 48 h after surgery (ml)a
 All included studies 4 160/155 −95.41 [−139.86, − 50.96] <  0.001 65% 0.04
 Randomized controlled trials 3 136/131 −105.78 [− 159.88, −51.68] 0.001 71% 0.03
 RTSA 3 111/106 −84.56 [−145.72, −23.39] 0.007 80% 0.007
 IV TXA 3 104/100 −110.04 [− 159.03, −61.06] <  0.0001 65% 0.04
 Topical TXA 1 56/55 −60.00 [−103.29, − 16.71] 0.007 NA NA
Operation time (min) 3 183/161 −1.08 [−4.91, 2.74] 0.58 0% 0.42
Hospital stay (day) 2 159/137 − 0.04 [− 0.45, 0.37] 0.84 75% 0.05
Overall complications 6 343/337 0.44 [0.07, 2.96] 0.40 0% 0.95
Thromboembolic events 6 343/337 0.31 [0.01, 7.40] 0.47 NA NA
  1. CI Confidence interval; Hb Hemoglobin; MD Mean difference; N Number of studies; NA Not applicable; RTSA Reverse total shoulder arthroplasty; TXA Tranexamic acid
  2. aData from Gillespie 2015 and Friedman 2017 were estimated from median and range