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Tranexamic acid may safely reduce blood loss in patients undergoing THA

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NATIONAL HARBOR, Md. — Tranexamic acid administration may safely reduce blood loss in patients who undergo elective primary total hip arthroplasty for acute femoral neck fracture, according to a speaker here.

Though administration tranexamic acid (TXA) in patients undergoing total hip arthroplasty (THA) may safely reduce blood loss, it did not make a significant difference in transfusions.

“Though TXA has not been approved by the FDA for use in orthopedic procedures, it has been shown to be safely and effectively reduce blood loss and transfusions in hip and knee arthroplasties,” Stephen A. Sems, MD, said at the Orthopaedic Trauma Association Annual Meeting.

The prospective, double-blinded, randomized, control study included 138 patients. Patients were randomized to receive TXA (69 patients) or placebo (69 patients) at the time of surgery and received follow-up at least 90 days after administration.

Stephen A. Sems

Researchers collected the following data: calculated blood loss, proportion of patients transfused, number of units transfused, hospital readmission and 30-day and 90-day complications, which included thromboembolic event, wound complication, reoperation and mortality.

Patients in the TXA group shown a mean reduced blood loss of 305 mL (P = .0005).  In addition, patients in the TXA group had no differences in adverse events at 30 days and 90 days, Sems said.

Overall, 17% of patients in the TXA group received transfusions and 26% of patients in the placebo group received transfusions, but the difference was not statistically significant (P = .022).

“This randomized clinical trial found that TXA administration safely reduced blood loss with a tendency for a decreased transfusion rate for patients undergoing hip arthroplasty for acute femoral neck fracture treatment,” Sems said. “Further studies could consider administering TXA earlier in the hospital course and could attempt to minimize the exclusion criteria, such as histories of thrombolytic events or coagulopathy.” – by Nhu Te

Reference:

Sems S. Paper #30. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 5-8, 2016; National Harbor, Md.

Disclosure: Sems reports no relevant financial disclosures.