Early use of tranexamic acid may not lower transfusion rates in patients with hip fracture
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Key takeaways:
- Results showed the tranexamic acid group had no difference in its blood transfusion rate vs. the placebo group.
- The two groups had no differences in estimated blood loss or complication rates.
SEATTLE — Results presented here showed early administration of tranexamic acid may not reduce blood transfusion rates among patients with isolated extracapsular hip fractures.
“For our primary outcome measure, there was no difference in transfusion between the treatment group and our placebo group,” Rachel Honig, MD, said in her presentation at the Orthopaedic Trauma Association Annual Meeting.
Honig and colleagues randomly assigned 128 patients (mean age, 79 years; 70% women) with isolated extracapsular hip fractures to receive either IV tranexamic acid or a saline placebo. Outcomes included the rate of blood transfusion per hospital stay, estimated blood loss and complications.
“For the treatment group, they got the 1 gram bolus over 10 minutes and the 1 gram infusion over 8 hours,” Honig said. “The placebo group got the same thing, just normal saline.”
Researchers found no statistically significant differences in the rate of blood transfusion between the treatment group and the placebo-controlled group. In addition, Honig said the two groups had no differences in estimated blood loss, even after stratifying the estimated blood loss by hospital days.
Honig also said the tranexamic acid and placebo groups had no differences in the rate of complications, including venous thromboembolic events, myocardial infarction, stroke and mortality.
“In summary, early administration of [tranexamic acid] did not reduce blood transfusion rates for extracapsular hip fractures, but this is a fragile patient population and further research is required to optimize the perioperative care of these patients,” Honig said.
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Honig R, et al. Paper 69. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 18-21, 2023; Seattle.
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