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Tranexamic acid had no benefit on transfusion rate, blood loss in acetabular surgery
Results published in The Journal of Orthopaedic Trauma showed no significant benefit in the use of tranexamic acid during acetabular fracture reconstruction with regard to the incidence of transfusion, transfusion volume, estimated blood loss or the incidence of venous thromboembolism compared with placebo.
“In contrast to the recent literature demonstrating a positive effect of tranexamic acid in reducing blood loss after arthroplasty procedures, our study was unable to identify a reduction in blood loss or the rate of transfusion after operative repair of acetabular fractures,” Madhav A. Karunakar, MD, told Healio.com/Orthopedics.
Karunakar and colleagues randomly assigned 88 patients who were undergoing acetabular fracture surgery to receive either tranexamic acid (TXA) or placebo. The primary outcome measure was transfusion of packed red blood cells, and secondary outcome measures included the number of units transfused, estimated blood loss and the incidence of venous thromboembolism (VTE).
Results showed an overall transfusion rate of 40.9% and an average estimated blood loss of 635 mL. Researchers noted no significant differences for the incidence of transfusion, number of units transfused, estimated blood loss or incidence of venous thromboembolism between the groups. Patients in the TXA group had no difference in transfusion rate. Patients with low preoperative hemoglobin levels, higher rates of intraoperative blood loss and longer surgical times were significantly more likely to undergo transfusion.
Karunakar noted the fracture and technical factors, such as injury complexity and surgical time, may have had a strong influence on blood loss and transfusion among these patients.
“Further studies with subgroups of fracture patients are needed to determine if a more modest effect is in fact present than we could detect in this study,” he said. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.