{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:24:58Z","timestamp":1782905098253,"version":"3.54.5"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Heart and Diabetes Centre North Rhine-Westphalia (DKZ NRW)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Anesth"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In cardiac surgery, use of the antifibrinolytic agent tranexamic acid (TXA) and acute perioperative stroke are both associated with convulsive seizures. We hypothesized that an older (preoperative) stroke increases the risk of TXA-associated seizures as well. To test this hypothesis, we retrospectively analyzed data from 16,110 patients who had undergone open-heart valvular surgery at our institution between 2009 and 2020. The dosing of TXA was moderate. Use of TXA and a history of stroke were both independently associated with convulsive seizure with an adjusted odds ratio (OR) of 2.40 (95%CI: 1.71\u20133.37) and 1.79 (95%CI: 1.27\u20132.54), respectively. Compared to patients without TXA administration, the adjusted OR of experiencing a seizure in TXA patients without a history of stroke was 2.44 (95%CI: 1.71\u20133.46) and in patients receiving TXA with a history of stroke 4.30 (95%CI: 2.65\u20136.99). However, there was no significant interaction between TXA use and preoperative stroke on convulsive seizures (<jats:italic>P<\/jats:italic>\u2009=\u20090.77). Compared to patients without seizure, for patients with seizure, the inverse probability-weighted ORs of in-hospital mortality and 30-day mortality were 3.58 (95%CI: 2.20\u20135.83) and 4.04 (95%CI: 2.34\u20136.98), respectively. We conclude that, in patients undergoing open-heart surgery, a history of stroke is independently associated with convulsive seizures but is not a contraindication for TXA use.<\/jats:p>","DOI":"10.1007\/s00540-021-02924-w","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T07:02:31Z","timestamp":1617692551000},"page":"451-454","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Associations of preoperative stroke and tranexamic acid administration with convulsive seizures in valvular open-heart surgery"],"prefix":"10.1007","volume":"35","author":[{"given":"Nikolai","family":"Hulde","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6085-6554","authenticated-orcid":false,"given":"Armin","family":"Zittermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus-Andr\u00e9","family":"Deutsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"von Dossow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan F.","family":"Gummert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Koster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"2924_CR1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.seizure.2016.02.011","volume":"36","author":"Z Lin","year":"2016","unstructured":"Lin Z, Xiaoyi Z. Tranexamic acid-associated seizures: a meta-analysis. Seizure. 2016;36:70\u20133.","journal-title":"Seizure"},{"key":"2924_CR2","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1002\/ana.24558","volume":"79","author":"I Lecker","year":"2016","unstructured":"Lecker I, Wang DS, Whissell PD, Avramescu S, Mazer CD, Orser BA. Tranexamic acid associated seizures: causes and treatment. Ann Neurol. 2016;79:18\u201326.","journal-title":"Ann Neurol"},{"key":"2924_CR3","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1056\/NEJMoa1606424","volume":"376","author":"PS Myles","year":"2017","unstructured":"Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, et al. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med. 2017;376:136\u201348.","journal-title":"N Engl J Med"},{"key":"2924_CR4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.pneurobio.2017.10.001","volume":"163\u2013164","author":"X Jiang","year":"2018","unstructured":"Jiang X, Andjelkovic AV, Zhu L, Yang T, Bennett MVL, Chen J, Keep RF, Shi Y. Blood-brain barrier dysfunction and recovery after ischemic stroke. Prog Neurobiol. 2018;163\u2013164:144\u201371.","journal-title":"Prog Neurobiol"},{"key":"2924_CR5","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1016\/S0140-6736(19)32233-0","volume":"394","author":"CRASH-3 trial collaborators","year":"2019","unstructured":"CRASH-3 trial collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet. 2019;394:1713\u201323.","journal-title":"Lancet"},{"key":"2924_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta23350","volume":"23","author":"N Sprigg","year":"2019","unstructured":"Sprigg N, Flaherty K, Appleton JP, Al-Shahi Salman R, Bereczki D, Beridze M. Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT. Health Technol Assess. 2019;23:1\u201348.","journal-title":"Health Technol Assess"}],"updated-by":[{"DOI":"10.1007\/s00540-021-02936-6","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000}}],"container-title":["Journal of Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00540-021-02924-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00540-021-02924-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00540-021-02924-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T22:10:18Z","timestamp":1627683018000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00540-021-02924-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,6]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["2924"],"URL":"https:\/\/doi.org\/10.1007\/s00540-021-02924-w","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s00540-021-02936-6","asserted-by":"object"}]},"ISSN":["0913-8668","1438-8359"],"issn-type":[{"value":"0913-8668","type":"print"},{"value":"1438-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,6]]},"assertion":[{"value":"31 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00540-021-02936-6","URL":"https:\/\/doi.org\/10.1007\/s00540-021-02936-6","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}}]}}