This multicenter, retrospective study used the Pediatric Health Information System database to examine TXA (Tranexamic acid) use for post tonsillectomy hemorrhage (PTH) across US children's hospitals, analyzing 19,572 ED encounters for PTH in children <18 years from 2016–2024. The study did not differentiate TXA by route of administration or doses.
TXA use is rapidly increasing but remains highly variable. Median annual TXA use rose dramatically from 0.0% in 2016 to 30.6% in 2024, yet individual hospital-level use ranged from 1.0% to 67.1%, reflecting a lack of standardized protocols and significant practice variation across institutions.
TXA was associated with reduced reoperation but not hospital admission. At the encounter level, TXA administration was associated with 34% lower adjusted odds of reoperation (aOR 0.66, 95% CI 0.56–0.77). However, there was no significant association with hospital admission (aOR 0.93, 95% CI 0.83–1.04).
References
Bergmann KR, Hall M, Ramgopal S, Badaki-Makun O, Chaudhari PP, Eltorki M, Geanacopoulos AT, Gonzalez F, Keating EM, Phamduy TT, Rees CA, Shapiro DJ, Chinnadurai S, Neuman MI. Tranexamic Acid Use for Posttonsillectomy Hemorrhage Across US Children's Hospitals. Pediatr Emerg Care. 2026 Apr 17. doi: 10.1097/PEC.0000000000003604. Epub ahead of print. PMID: 41992793.