ISSN : 2663-2187

The Significant Effect of Administering Tranexamic Acid Intraoperatively on The Scoring of Ecchymosis in Various Timeframes of Rhinoplastic Procedures

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MOHAMMAD AL KATATBEH, MD, YAZAN AL-MASHAKBEH, MD, OBEIDALLAH ALKHATATBEH, MD, HOUSAM ALSAIDI, BSN, HADEEL FREIHAT, MD, HIBA GHARAM, MD, REEMA SHORMAN, MD
» doi: 10.48047/AFJBS.6.12.2024.570-592

Abstract

Objectives: The study aimed to assess the impact of procedural timeframe in minutes on the probability of post-rhinoplastic ecchymosis. It was conducted using a binary logistic regression analysis and multiple logistic regression analysis to examine the relationship between the duration of patients' procedures and the likelihood of post-procedural ecchymosis. The study also introduced a major binary state of comparison, the non-experienced TXA cohort versus the experienced TXA cohort, to the previous binary logistic regression analysis. Methods:A study involving patients who had undergone various rhinoplastic procedures was conducted. Patients excluded due to previous surgery, cardiovascular or coagulopathy disorders, uncontrolled bold pressure, or being younger than 18 or older than 60 years old or requiring an additional osteotomy were also excluded. The study obtained approval from the Institutional Review Board/Human Subjects Committee of the Faculty of Medicine-Hashemite University. Patient information was obtained through retrospective review of hospital records. The primary result was the evaluation of periorbital ecchymoses following surgery using the grading system developed by Kara et al. The study divided eligible patients into binary cohorts based on TXA, with Group I not receiving intraoperative TXA IV and Group II receiving TXA IV. The statistical correlation between the duration of rhinoplastic procedures and the severity of post-procedural ecchymosis was analyzed using ROC curve analysis. A binary. Multiple, and cox regressional statistical analysis were also conducted in this study. Results:The optimal rhinoplastic procedure for the Jordanian cohort was determined at 100.50 minutes, with a probability of post-rhinoplastic ecchymosis >3 at the explored optimal point being 50.02%.The study also found that the primary binary variable of investigation, TXA experiencing, was significantly linked to a lower risk of having a higher ecchymosis risk when given intraoperatively. The addition of binary interventional TXA therapy improved the corresponding sensitivity, specificity, positive and negative predictive values, as well as the accuracy index by 70.1%, 71.2%, 71.6%, 69.6%, and 70.6%, respectively.The study also investigated the impact of provision intraoperatively of TXA IV against the probability of a post-rhinoplastic ecchymosis score exceeding 3 while considering the procedural duration timeframe in minutes across patients' age strata via cox-regressional proportional hazard modelling. The adjusted odd ratio for having a post-rhinoplastic ecchymosis score >3 when an intraoperative TXA IV was provided versus a non-experiencing TXA IV in a comparative cohort was significantly determined at 0.417 (95% CI; 0.283–0.614). Conclusion:Multiple logistic regression and cox-regressional proportional hazard modelling showed that intraoperative TXA IV reduced the probability of post-rhinoplastic ecchymosis scores exceeding grade 3 across various attended patients' ages and procedural timeframes.

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