Four RCTs (n=153) were included.
Tranexamic acid was associated with a significant reduction in the frequency of red cell transfusions (RR 0.48, 95% CI: 0.24, 0.97, p=0.041), transfusion of any allogeneic blood component (RR 0.50, 95% CI: 0.26, 0.94, p=0.032) and ln(blood loss) (SMD -1.72, 95% CI: -2.05, -1.39, p<0.001) compared with placebo. There was evidence of borderline heterogeneity for the analysis of blood loss (p=0.041) but not for the other two analyses.
It was not possible to conduct a meta-analysis of thromboembolic events because of zero frequencies in some studies.