Tranexamic acid-associated seizures: A meta-analysis

• The risk of seizure increased in patients with tranexamic acid exposure.
• The incidence rate of tranexamic acid-associated seizures increased when the dose levels increased.
• Low tranexamic acid dose also possibly increases the risk of seizure.

PurposeTo investigate the incidence rate of tranexamic acid (TXA)-associated seizures.MethodsTwo electronic databases (Medline and Embase) were searched. We looked for additional studies in the references of all identified publications. The cutoff day was 2015 Dec 06. Two authors independently reviewed the titles and abstracts of the publications identified firstly. Odds ratio (OR) and 95% confidence interval (CI) were used to compare discontinuous variables.ResultsTen studies enrolling 26,079 patients with TXA exposure and 7395 patients with non-TXA exposure were included. The cumulative incidence rate of TXA-associated seizures is 2.7%. The odds ratio of seizure is 5.39 (95%CI: 3.29–8.85; I2 = 0%; P < 0.001) in patients with TXA exposure vs patients with non-TXA exposure. The incidence rate of TXA-associated seizures increased when the dose levels increased.ConclusionThe risk of seizure increased in patients with TXA exposure and the incidence rate of TXA-associated seizures increased when the dose levels increased.