{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:50:46Z","timestamp":1767923446341,"version":"3.49.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p>Recent studies support the prophylactic use of tranexamic acid during craniosynostosis surgery to reduce blood loss. The study aims to assess national trends and outcomes of tranexamic acid administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>The Pediatric Health Information System database was used to identify patients who underwent craniosynostosis surgery over a 9-year period (2010 to 2018). Search criteria included patients younger than 2 years with a primary diagnosis of craniosynostosis (<jats:italic toggle=\"yes\">International Classification of Diseases, Ninth Revision<\/jats:italic>, 756.0;<jats:italic toggle=\"yes\">International Classification of Diseases, Tenth Revision<\/jats:italic>, Q75.0) and CPT code for craniotomy (61550 to 61559). Tranexamic acid use, complications, length of stay, and transfusion requirements were recorded. Subgroup analysis was performed for fronto-orbital advancements and single-suture surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>A total of 1345 patients were identified. Mean patient age was 229 \u00b1 145 days. Four hundred fifty-four patients (33.7 percent) received tranexamic acid. Tranexamic acid use increased from 13.1 percent in 2010 to 75.6 percent in 2018 (<jats:italic toggle=\"yes\">p<\/jats:italic>= 0.005), and mean blood products per patient increased from 1.09 U to 1.6 U (<jats:italic toggle=\"yes\">p<\/jats:italic>= 0.009). Surgical complication rate was higher in those receiving tranexamic acid (16.7 percent versus 11.1 percent;<jats:italic toggle=\"yes\">p<\/jats:italic>= 0.004). Tranexamic acid administration was associated with increased transfusion requirements on univariate and multivariate analysis (1.76 U versus 1.18 U; OR, 2.03;<jats:italic toggle=\"yes\">p<\/jats:italic>&lt; 0.001). In the fronto-orbital advancement subgroup, those receiving tranexamic acid received more total blood products (2.2 U versus 1.8 U;<jats:italic toggle=\"yes\">p<\/jats:italic>= 0.02); this difference was present but not significant within the single-suture group (0.69 U versus 0.50 U;<jats:italic toggle=\"yes\">p<\/jats:italic>= 0.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Tranexamic acid use in craniosynostosis surgery has increased dramatically since 2010. However, it was associated with higher transfusion and complication rates in this data set. Optimization of its use and blood loss mitigation in infant craniosynostosis deserve continued research.<\/jats:p><\/jats:sec><jats:sec><jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title><jats:p>Therapeutic, III.<\/jats:p><\/jats:sec>","DOI":"10.1097\/prs.0000000000007245","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:04:44Z","timestamp":1603411484000},"page":"1119-1127","source":"Crossref","is-referenced-by-count":14,"title":["Tranexamic Acid in Infantile Craniosynostosis Surgery: Friend or Foe?"],"prefix":"10.1097","volume":"146","author":[{"given":"Rachel M.","family":"Danforth","sequence":"first","affiliation":[{"name":"From the Divisions of Plastic Surgery and Pediatric Gastroenterology, Indiana University and Riley Hospital for Children."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia A.","family":"Cook","sequence":"additional","affiliation":[{"name":"From the Divisions of Plastic Surgery and Pediatric Gastroenterology, Indiana University and Riley Hospital for Children."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William E.","family":"Bennett","sequence":"additional","affiliation":[{"name":"From the Divisions of Plastic Surgery and Pediatric Gastroenterology, Indiana University and Riley Hospital for Children."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil S.","family":"Tholpady","sequence":"additional","affiliation":[{"name":"From the Divisions of Plastic Surgery and Pediatric Gastroenterology, Indiana University and Riley Hospital for Children."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A.","family":"Gerety","sequence":"additional","affiliation":[{"name":"From the Divisions of Plastic Surgery and Pediatric Gastroenterology, Indiana University and Riley Hospital for Children."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"R1-20230801","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1097\/PRS.0000000000000093","article-title":"Evidence-based medicine: Craniosynostosis.","volume":"133","author":"Fearon","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"R2-20230801","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1097\/00006534-200206000-00002","article-title":"The use of recombinant erythropoietin in the reduction of blood transfusion rates in craniosynostosis repair in infants and children.","volume":"109","author":"Fearon","year":"2002","journal-title":"Plast Reconstr Surg"},{"key":"R3-20230801","first-page":"CD004863","article-title":"Early erythropoietin for preventing red blood cell transfusion in preterm and\/or low birth weight infants.","volume":"3","author":"Ohlsson","year":"2006","journal-title":"Cochrane Database 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