Efficacy and safety of tranexamic acid in hip fracture surgery: A comparative study of 613 patients

Background Blood loss is a major concern in the frail elderly patient undergoing hip fracture surgery. The objective of this study was to investigate the efficacy of tranexamic acid in reducing blood loss and allogenic blood transfusions. The study also investigated the safety profile by comparing r...

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Bibliographic Details
Published in:Journal of perioperative practice 2022-04, Vol.32 (4), p.90-94
Main Authors: AlSumadi, Mutaz, Mahmood, Aatif, Whittam, David, Kharma, Lara, Ashour, Rami, Banim, Ronan
Format: Article
Language:English
Subjects:
Acids
Antifibrinolytic agents
Blood transfusions
Fractures
Hemoglobin
Orthopedics
Perioperative care
Postoperative period
Thromboembolism
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Summary:Background Blood loss is a major concern in the frail elderly patient undergoing hip fracture surgery. The objective of this study was to investigate the efficacy of tranexamic acid in reducing blood loss and allogenic blood transfusions. The study also investigated the safety profile by comparing rates of thromboembolic events, Methods A total of 613 patients with hip fractures were included in the study. Patients received 1g of tranexamic acid on induction of anaesthesia. Postoperative haemoglobin was measured on day one. Blood loss was calculated, and blood transfusion was recorded. Results Tranexamic acid use resulted in a higher mean postoperative haemoglobin (110.3 ± 15.9 vs 106.8 ± 16.2; p = 0.023) and reduced mean estimated blood loss (571.3 ± 150.4 vs 678.3 ± 201.2; p = 0.001). There was also a significantly reduced number of transfusions in tranexamic acid group (13% vs 28%; p = 0.002). There was no difference in rates of deep vein thrombosis (4 vs 3; p = 0.98) or pulmonary embolism (2 vs 2; p = 1). Conclusion The use of tranexamic acid is effective in reduction of blood loss and rates of blood transfusion, without an apparent increase in adverse thromboembolic events.
ISSN:1750-4589
2515-7949
DOI:10.1177/17504589211002090