{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T10:54:00Z","timestamp":1791629640193,"version":"4.3.4"},"reference-count":55,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"\n Importance<\/jats:title>\n Tranexamic acid (TXA) is increasingly used to minimize perioperative bleeding. However, its efficacy and safety profile across general surgical procedures remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the efficacy and safety of prophylactic TXA in reducing intraoperative blood loss, need for transfusion, and major bleeding in general surgery, while assessing its association with thromboembolic events and mortality.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n PubMed, Embase, and Cochrane Library were systematically searched from inception to April 3, 2025.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Randomized clinical trials (RCTs) comparing TXA to placebo in adult patients undergoing general surgery and reporting at least 1 predefined outcome of interest were included.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n \n Two reviewers independently extracted data and assessed risk of bias. Mean differences (MDs) and risk ratios (RRs) with 95% CIs were pooled using random-effects models. Heterogeneity was assessed using the\n I<\/jats:italic>\n 2<\/jats:sup>\n statistic.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty-six RCTs with a total of 6976 patients were included. TXA use was associated with lower intraoperative blood loss (MD, \u221235.85 mL; 95% CI, \u221257.20 to \u221214.51 mL;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200991%;\n P<\/jats:italic>\n \u2009=\u2009.001), reduced need for transfusion (RR, 0.75; 95% CI, 0.60-0.94;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200954%;\n P<\/jats:italic>\n \u2009=\u2009.01), and fewer major bleeding events (RR, 0.72; 95% CI, 0.59-0.89;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%;\n P<\/jats:italic>\n \u2009=\u2009.002). No significant differences were found in venous thromboembolism (RR, 1.09; 95% CI, 0.62-1.92;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200915%;\n P<\/jats:italic>\n \u2009=\u2009.75), mortality (RR, 1.08; 95% CI, 0.72-1.61;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%;\n P<\/jats:italic>\n \u2009=\u2009.71), and length of stay (MD, \u22120.54 days; 95% CI, \u22121.15 to 0.06 days;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200973%;\n P<\/jats:italic>\n \u2009=\u2009.08). In the subgroup analysis restricted to abdominal procedures, the benefits observed in the overall population on intraoperative blood loss and need for transfusion were no longer present. In the hepatobiliary subgroup, TXA was associated with a significant reduction in major bleeding (RR, 0.59; 95% CI, 0.39-0.90;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%;\n P<\/jats:italic>\n \u2009=\u2009.01), while no significant differences were observed for the other outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This systematic review and meta-analysis found that prophylactic TXA use was associated with lower intraoperative blood loss, transfusion requirements, and major bleeding without an observed increase in thromboembolic or mortality risk. Although these findings support the use of TXA in general surgery procedures, the decision to use TXA should be individualized considering individual patient characteristics and the specific procedure being performed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2025.5498","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T17:30:28Z","timestamp":1765992628000},"page":"179","source":"Crossref","is-referenced-by-count":15,"title":["Perioperative Use of Tranexamic Acid in General Surgery"],"prefix":"10.1001","volume":"161","author":[{"given":"Lucas Monteiro","family":"Delgado","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo Fontel","family":"Pompeu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Heli\u00f3polis Hospital, S\u00e3o Paulo-SP, Brazil"},{"name":"Universidade Municipal de S\u00e3o Caetano do Sul (USCS), S\u00e3o Paulo-SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Henrique Acedo","family":"Martins","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Lima","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Pasqualotto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Santa Catarina, Florian\u00f3polis-SC, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago Celestino","family":"Chulam","sequence":"additional","affiliation":[{"name":"AC Camargo Cancer Center, S\u00e3o Paulo-SP, Brazil"},{"name":"Universidade Federal do Esp\u00edrito Santo, Vit\u00f3ria-ES, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9rgio Mazzola Poli","family":"de Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"soi250084r1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1136\/jcp.s3-14.1.41","article-title":"Clinical pharmacology of aminocaproic and tranexamic acids.","volume":"14","author":"Nilsson","year":"1980","journal-title":"J Clin Pathol Suppl (R Coll Pathol)"},{"issue":"5","key":"soi250084r2","doi-asserted-by":"publisher","first-page":"585","DOI":"10.2165\/11209070-000000000-00000","article-title":"Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis.","volume":"72","author":"McCormack","year":"2012","journal-title":"Drugs"},{"issue":"5","key":"soi250084r3","doi-asserted-by":"publisher","first-page":"S171","DOI":"10.1097\/XCS.0000000000001163","article-title":"Safety and efficacy of tranexamic acid use in general surgery patients: a sub-study of the POISE-3 randomized controlled trial.","volume":"239","author":"Park","year":"2024","journal-title":"J Am Coll Surg"},{"issue":"2","key":"soi250084r4","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1056\/NEJMoa1606424","article-title":"Tranexamic acid in patients undergoing coronary-artery surgery.","volume":"376","author":"Myles","year":"2017","journal-title":"N Engl J Med"},{"issue":"2","key":"soi250084r5","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/j.jtcvs.2018.09.113","article-title":"Tranexamic acid in coronary artery surgery: one-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial.","volume":"157","author":"Myles","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"4","key":"soi250084r6","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1016\/j.arthro.2021.10.001","article-title":"Tranexamic acid administration in arthroscopic surgery is a safe adjunct to decrease postoperative pain and swelling: a systematic review and meta-analysis.","volume":"38","author":"Goldstein","year":"2022","journal-title":"Arthroscopy"},{"issue":"2","key":"soi250084r7","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.arthro.2021.07.030","article-title":"Tranexamic acid use in anterior cruciate ligament reconstruction decreases bleeding complications: a systematic review and meta-analysis of randomized controlled trials.","volume":"38","author":"Alkhatib","year":"2022","journal-title":"Arthroscopy"},{"key":"soi250084r8","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.bjps.2024.09.085","article-title":"Role of tranexamic acid (TXA) in plastic and reconstructive surgery: a national perspective.","volume":"102","author":"Rohrich","year":"2025","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"soi250084r10","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.ahj.2023.02.008","article-title":"Perioperative bleeding and outcomes after noncardiac surgery.","volume":"260","author":"Smilowitz","year":"2023","journal-title":"Am Heart J"},{"issue":"71","key":"soi250084r12","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"soi250084r15","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials.","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"issue":"7454","key":"soi250084r16","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1136\/bmj.328.7454.1490","article-title":"Grading quality of evidence and strength of recommendations.","volume":"328","author":"Atkins","year":"2004","journal-title":"BMJ"},{"issue":"7109","key":"soi250084r17","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test.","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"issue":"3","key":"soi250084r18","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials.","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"issue":"18","key":"soi250084r19","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.1002\/sim.1221","article-title":"A graphical method for exploring heterogeneity in meta-analyses: application to a meta-analysis of 65 trials.","volume":"21","author":"Baujat","year":"2002","journal-title":"Stat Med"},{"issue":"2","key":"soi250084r20","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1002\/jrsm.11","article-title":"Outlier and influence diagnostics for meta-analysis.","volume":"1","author":"Viechtbauer","year":"2010","journal-title":"Res Synth Methods"},{"issue":"1","key":"soi250084r21","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/anae.14705","article-title":"Trial sequential analysis: adding a new dimension to meta-analysis.","volume":"75","author":"Shah","year":"2020","journal-title":"Anaesthesia"},{"issue":"11","key":"soi250084r22","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1002\/sim.1187","article-title":"How should meta-regression analyses be undertaken and interpreted?","volume":"21","author":"Thompson","year":"2002","journal-title":"Stat Med"},{"issue":"1","key":"soi250084r23","doi-asserted-by":"publisher","first-page":"30","DOI":"10.5005\/jp-journals-10033-1266","article-title":"The effect of tranexamic acid on blood loss during laparoscopic sleeve gastrectomy.","volume":"9","author":"Alhomoud","year":"2016","journal-title":"World J Laparosc Surg"},{"issue":"5","key":"soi250084r24","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1097\/00000542-199611000-00012","article-title":"Tranexamic acid reduces blood loss, transfusion requirements, and coagulation factor use in primary orthotopic liver transplantation.","volume":"85","author":"Boylan","year":"1996","journal-title":"Anesthesiology"},{"issue":"1","key":"soi250084r25","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/00000539-200007000-00006","article-title":"Tranexamic acid reduces red cell transfusion better than epsilon-aminocaproic acid or placebo in liver transplantation.","volume":"91","author":"Dalmau","year":"2000","journal-title":"Anesth Analg"},{"issue":"13","key":"soi250084r26","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1001\/jama.2024.11783","article-title":"Tranexamic acid in patients undergoing liver resection: the HeLiX randomized clinical trial.","volume":"332","author":"Karanicolas","year":"2024","journal-title":"JAMA"},{"issue":"1","key":"soi250084r27","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s12871-025-02935-0","article-title":"Use of tranexamic acid in hepatectomy under controlled low central venous pressure: a randomized controlled study.","volume":"25","author":"Luo","year":"2025","journal-title":"BMC Anesthesiol"},{"issue":"12","key":"soi250084r29","doi-asserted-by":"publisher","first-page":"3962","DOI":"10.1007\/s11695-023-06902-x","article-title":"Effect of tranexamic acid on postoperative bleeding in sleeve gastrectomy: a randomized trial.","volume":"33","author":"Sermet","year":"2023","journal-title":"Obes Surg"},{"issue":"11","key":"soi250084r30","doi-asserted-by":"publisher","first-page":"531","DOI":"10.53350\/pjmhs20221611531","article-title":"Peri-operative use of transexamic acid in reduction of post operative seroma formation in patients undergoing ventral hernia repair.","volume":"16","author":"Siddiqui","year":"2022","journal-title":"Pak J Med Health Sci"},{"issue":"10","key":"soi250084r31","doi-asserted-by":"publisher","first-page":"7455","DOI":"10.1007\/s00464-023-10232-5","article-title":"Peroperative administration of tranexamic acid in sleeve gastrectomy to reduce hemorrhage: a double-blind randomized controlled trial.","volume":"37","author":"\u2019t Hart","year":"2023","journal-title":"Surg Endosc"},{"issue":"2","key":"soi250084r32","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1093\/bjs\/znac382","article-title":"Tranexamic acid and blood loss in pancreaticoduodenectomy: TAC-PD randomized clinical trial.","volume":"110","author":"Ishii","year":"2023","journal-title":"Br J Surg"},{"issue":"2","key":"soi250084r33","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1097\/01.sla.0000197561.70972.73","article-title":"Perioperative parenteral tranexamic acid in liver tumor resection: a prospective randomized trial toward a \u201cblood transfusion\u201d-free hepatectomy.","volume":"243","author":"Wu","year":"2006","journal-title":"Ann Surg"},{"key":"soi250084r34","doi-asserted-by":"publisher","first-page":"3905","DOI":"10.2147\/JPR.S426872","article-title":"Safe and Effective Blood Preservation Through Acute Normovolemic Hemodilution and Low-Dose Tranexamic Acid in Open Partial Hepatectomy.","volume":"16","author":"Yang","year":"2023","journal-title":"J Pain Res"},{"key":"soi250084r35","article-title":"Single dose of IV tranexamic acid preoperatively reduces the incidence of post-operative scrotal edema following lichtenstein hernioplasty. a randomized prospective cohort analysis.","author":"Zaheer","year":"2021","journal-title":"Medical Forum Monthly"},{"issue":"8","key":"soi250084r36","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/j.jclinane.2011.03.004","article-title":"The effect of intravenous tranexamic acid on blood loss and surgical field quality during endoscopic sinus surgery: a placebo-controlled clinical trial.","volume":"23","author":"Alimian","year":"2011","journal-title":"J Clin Anesth"},{"issue":"6","key":"soi250084r37","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/BF01773442","article-title":"Antifibrinolytic therapy for prevention of hemorrhage during surgery of the thyroid gland.","volume":"65","author":"Auvinen","year":"1987","journal-title":"Klin Wochenschr"},{"issue":"12","key":"soi250084r38","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.20190","article-title":"Effect of two different tranexamic acid doses on blood loss in head and neck cancer surgery: a randomized, double-blind, controlled study.","volume":"13","author":"Babu","year":"2021","journal-title":"Cureus"},{"issue":"6","key":"soi250084r39","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/j.otohns.2008.02.022","article-title":"Prospective, randomized, controlled trial of tranexamic acid in patients who undergo head and neck procedures.","volume":"138","author":"Chen","year":"2008","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"1","key":"soi250084r40","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s12070-010-0095-4","article-title":"A randomized control trial to verify the efficacy of pre-operative intra venous tranexamic acid in the control of tonsillectomy bleeding.","volume":"63","author":"George","year":"2011","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"issue":"1","key":"soi250084r41","doi-asserted-by":"publisher","first-page":"19","DOI":"10.4103\/0019-5049.174798","article-title":"Does tranexamic acid reduce blood loss during head and neck cancer surgery?","volume":"60","author":"Kulkarni","year":"2016","journal-title":"Indian J Anaesth"},{"issue":"12","key":"soi250084r42","doi-asserted-by":"publisher","first-page":"UC05","DOI":"10.7860\/JCDR\/2019\/42939.13349","article-title":"Comparative study of two different intravenous doses of tranexamic acid with placebo on surgical field quality in functional endoscopic sinus surgery\u2014a randomised clinical trial.","volume":"13","author":"Pannerselvam","year":"2019","journal-title":"J Clin Diagn Res"},{"issue":"12","key":"soi250084r43","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1017\/S0022215119002305","article-title":"Tranexamic acid has no advantage in head and neck surgical procedures: a randomised, double-blind, controlled clinical trial.","volume":"133","author":"Thakur","year":"2019","journal-title":"J Laryngol Otol"},{"key":"soi250084r44","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.771159","article-title":"Intravenous tranexamic acid improves the intraoperative visualization of endoscopic sinus surgery for high-grade chronic rhinosinusitis: a randomized, controlled, double-blinded prospective trial.","volume":"8","author":"Yang","year":"2021","journal-title":"Front Surg"},{"issue":"2","key":"soi250084r45","doi-asserted-by":"publisher","first-page":"194","DOI":"10.4103\/ija.ija_576_22","article-title":"Evaluation of efficacy and safety of a single dose tranexamic acid in reducing blood loss during colorectal cancer surgery: a randomised, placebo controlled, double-blinded study.","volume":"67","author":"Shaker","year":"2023","journal-title":"Indian J Anaesth"},{"issue":"3","key":"soi250084r46","first-page":"46","article-title":"Does intravenous tranexamic acid reduce bleeding during mastoidectomy?","volume":"10","author":"Ziaei","year":"2020","journal-title":"Am J Blood Res"},{"issue":"2","key":"soi250084r47","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1097\/00000539-199708000-00007","article-title":"Continuous small-dose tranexamic acid reduces fibrinolysis but not transfusion requirements during orthotopic liver transplantation.","volume":"85","author":"Kaspar","year":"1997","journal-title":"Anesth Analg"},{"issue":"9734","key":"soi250084r48","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/S0140-6736(10)60835-5","article-title":"Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.","volume":"376","author":"Shakur","year":"2010","journal-title":"Lancet"},{"issue":"3","key":"soi250084r49","doi-asserted-by":"publisher","first-page":"e313","DOI":"10.1097\/CCM.0000000000005362","article-title":"Tranexamic acid in gastrointestinal bleeding: a systematic review and meta-analysis.","volume":"50","author":"Dionne","year":"2022","journal-title":"Crit Care Med"},{"issue":"2","key":"soi250084r50","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1097\/HEP.0000000000000817","article-title":"Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis: a randomized controlled trial.","volume":"80","author":"Kumar","year":"2024","journal-title":"Hepatology"},{"issue":"8","key":"soi250084r51","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1016\/j.hpb.2025.05.006","article-title":"Safety and efficacy of tranexamic acid in hepatic surgery: a meta-analysis of randomized controlled trials.","volume":"27","author":"de Jesus","year":"2025","journal-title":"HPB (Oxford)"},{"key":"soi250084r52","doi-asserted-by":"publisher","DOI":"10.1177\/10760296251342467","article-title":"Tranexamic acid in patients undergoing liver resection: an updated systematic review and meta-analysis of randomized controlled trials.","volume":"31","author":"Tanashat","year":"2025","journal-title":"Clin Appl Thromb Hemost"},{"issue":"1","key":"soi250084r53","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1053\/j.gastro.2019.03.070","article-title":"AGA clinical practice update: coagulation in cirrhosis.","volume":"157","author":"O\u2019Leary","year":"2019","journal-title":"Gastroenterology"},{"issue":"2","key":"soi250084r54","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.athoracsur.2024.06.039","article-title":"Cardiac surgical bleeding, transfusion, and quality metrics: joint consensus statement by the enhanced recovery after surgery cardiac society and society for the advancement of patient blood management.","volume":"119","author":"Salenger","year":"2025","journal-title":"Ann Thorac Surg"},{"issue":"9","key":"soi250084r55","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002716","article-title":"Cost-effectiveness analysis of tranexamic acid for the treatment of traumatic brain injury, based on the results of the CRASH-3 randomised trial: a decision modelling approach.","volume":"5","author":"Williams","year":"2020","journal-title":"BMJ Glob Health"},{"key":"soi250084r14","author":"Wohlin","year":"2014"},{"key":"soi250084r9","unstructured":"General surgery: global trends & opportunities. Life Science Intelligence. Accessed May 2, 2025. https:\/\/www.lifesciencemarketresearch.com\/market-reports\/general-surgery-global-trends-opportunities-2018"},{"key":"soi250084r11","unstructured":"Higgins? JPT, Thomas? J, Chandler? J, . Cochrane Handbook for Systematic Reviews of Interventions, version 6.4. Updated August 22, 2024. Accessed April 5, 2025. http:\/\/www.training.cochrane.org\/handbook"},{"key":"soi250084r13","unstructured":"Delgado L, Pompeu B, Martins G, Pe\u00f1aranda L. Safety and efficacy of tranexamic acid in general surgery: a systematic review and meta-analysis of randomized controlled trials. PROSPERO 2025 CRD420251038412. April 23, 2025. Accessed November 11, 2025. https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251038412"},{"key":"soi250084r28","unstructured":"Prospective randomized phase IV open label comparative study of tranexamic acid plus standard of care vs standard of care for the reduction of blood loss in patients undergoing major abdominal surgery. ClinicalTrials.gov identifier: NCT00827931. Updated April 26, 2012. Accessed April 20, 2025. http:\/\/clinicaltrials.gov\/show\/nct00827931"}],"container-title":["JAMA Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamasurgery\/articlepdf\/2843043\/jamasurgery_delgado_2025_oi_250084_1770066741.45086.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:00:24Z","timestamp":1770825624000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamasurgery\/fullarticle\/2843043"}},"subtitle":["A Systematic Review and Meta-Analysis"],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":55,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamasurg.2025.5498","relation":{},"ISSN":["2168-6254"],"issn-type":[{"value":"2168-6254","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}