Results
A total number of 260 patients were included in the study; 106 were given TXA and 154 patients were not given any. There were four patients, post November 2017, who were deemed to have possible contraindications to TXA and therefore were not given any. One patient previously had a pulmonary embolus, one was on hormone replacement therapy, one had a history of atrial fibrillation and for one patient it is unclear why they were deemed unsuitable for TXA. There were 208 female patients and 52 male. Table 1 shows the characteristics of patients in the two groups.
In the first cohort who did not receive TXA, five patients were returned to theatre. In the comparison, the second cohort who did receive TXA, no patients returned to theatre. This was statistically significant (p =0.041). The results are summarised in table 2. There was no statistical difference between the equipment used and return to theatrep =0.884. All five patients that returned to theatre did not have bleeding from a named blood vessel, they had generalised slow bleeding. One of the patients had uncontrolled hypertension peri-operatively, one went into urinary retention immediately post-operatively, one patient had uncontrolled Graves’ disease and was a smoker who had continual coughing post-operatively and one patient had thyrotoxicosis that was controlled only shortly before surgery. For one patient there was no plausible explanation for post-operative bleeding. The other 3 patients underwent thyroid surgery for thyroid cancer. None of the patients were on anticoagulation or anti-platelet therapy.
There were no adverse outcomes recorded from TXA administration, specifically no patients had thromboembolic events. Only one patient who did not receive TXA was readmitted with temporary hypocalcaemia.