A Fígar1, S Mc Loughlin2, P A Slullitel3, W Scordo4, M A Buttaro3. 1. Anesthesiology Department, Italian Hospital of Buenos Aires, Peron 4190, C1181ACH, Buenos Aires, Argentina. 2. Anesthesiology Department, Italian Hospital of Buenos Aires, Peron 4190, C1181ACH, Buenos Aires, Argentina. santiago.mcloughlin@hospitalitaliano.org.ar. 3. Institute of Orthopedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, Buenos Aires, Argentina. 4. Transfusion Medicine and Hemotherapy Department, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Abstract
INTRODUCTION: To determine the effects of tranexamic acid (TXA) on transfusions in patients undergoing hip replacement with a hybrid or cementless prosthesis. METHODS: A group of 172 consecutive patients aged 18 years or older who underwent elective hip replacement with uncemented or hybrid prostheses, undergoing surgery between January 2012 and January 2014 by the same primary surgeon and anesthesiologist, were retrospectively included. TXA (1 g) was administered immediately before incision in the TXA group. Primary variables included number of red blood cell transfusions and the influence of TXA for each type of prosthesis. Secondary variables included hematocrit at discharge, length of hospital stay, thrombosis or pulmonary embolism, seizures, and death. RESULTS: Average transfusion was 1.53 units/patient in the control group compared to 0.6 units/patient in the TXA group (z = 6.29; U = 1640.5; p < 0.0001). TXA use was significantly correlated with the number of units transfused (p < 0.0001, 95% CI -1.24 to -0.68). Odds risk reduction for transfusion was observed during surgery (OR: 0.14; CI 0.06-0.29; p < 0.0001) and during the rest of hospital stay (OR: 0.11; CI 0.01-0.96; p = 0.046). Both hybrid and cementless prostheses that received TXA were transfused less than control groups (0.57 ± 1 vs. 1.7 ± 1 p < 0.01 and 0.65 ± 1 vs. 1.24 ± 1 p < 0.01). No difference was observed between the groups regarding adverse effects. Hematocrit values at discharge and length of hospital stay were similar between groups. No deaths were observed during hospital stay. CONCLUSIONS: TXA reduced transfusions without increasing the prevalence of adverse effects. This reduction was observed during surgery and the following days of hospital stay for both for hybrid and cementless prosthesis.
INTRODUCTION: To determine the effects of tranexamic acid (TXA) on transfusions in patients undergoing hip replacement with a hybrid or cementless prosthesis. METHODS: A group of 172 consecutive patients aged 18 years or older who underwent elective hip replacement with uncemented or hybrid prostheses, undergoing surgery between January 2012 and January 2014 by the same primary surgeon and anesthesiologist, were retrospectively included. TXA (1 g) was administered immediately before incision in the TXA group. Primary variables included number of red blood cell transfusions and the influence of TXA for each type of prosthesis. Secondary variables included hematocrit at discharge, length of hospital stay, thrombosis or pulmonary embolism, seizures, and death. RESULTS: Average transfusion was 1.53 units/patient in the control group compared to 0.6 units/patient in the TXA group (z = 6.29; U = 1640.5; p < 0.0001). TXA use was significantly correlated with the number of units transfused (p < 0.0001, 95% CI -1.24 to -0.68). Odds risk reduction for transfusion was observed during surgery (OR: 0.14; CI 0.06-0.29; p < 0.0001) and during the rest of hospital stay (OR: 0.11; CI 0.01-0.96; p = 0.046). Both hybrid and cementless prostheses that received TXA were transfused less than control groups (0.57 ± 1 vs. 1.7 ± 1 p < 0.01 and 0.65 ± 1 vs. 1.24 ± 1 p < 0.01). No difference was observed between the groups regarding adverse effects. Hematocrit values at discharge and length of hospital stay were similar between groups. No deaths were observed during hospital stay. CONCLUSIONS:TXA reduced transfusions without increasing the prevalence of adverse effects. This reduction was observed during surgery and the following days of hospital stay for both for hybrid and cementless prosthesis.
Authors: Samik Banerjee; Kimona Issa; Robert Pivec; Mark J McElroy; Harpal S Khanuja; Steven F Harwin; Michael A Mont Journal: J Knee Surg Date: 2013-08-16 Impact factor: 2.757
Authors: Blake P Gillette; Lori J DeSimone; Robert T Trousdale; Mark W Pagnano; Rafael J Sierra Journal: Clin Orthop Relat Res Date: 2013-01 Impact factor: 4.176
Authors: Borja Barrachina; Amanda Lopez-Picado; Maria Remon; Ana Fondarella; Ibai Iriarte; Rebeca Bastida; Alicia Rodríguez-Gascón; Maria Aranzazu Achaerandio; Maria Carmen Iturricastillo; Felipe Aizpuru; Cesar Augusto Valero; Ricardo Tobalina; Roberto Hernanz Journal: Anesth Analg Date: 2016-04 Impact factor: 5.108
Authors: Andrew G Golz; Heather K Yee; Benjamin J Davis; William H Adams; Nicholas M Brown Journal: J Am Acad Orthop Surg Date: 2021-06-01 Impact factor: 4.000
Authors: Andreas Fontalis; Daniel J Berry; Andrew Shimmin; Pablo A Slullitel; Martin A Buttaro; Cao Li; Henrik Malchau; Fares S Haddad Journal: SICOT J Date: 2021-11-30
Authors: Alessandro Jachetti; Rose Berly Massénat; Nathalie Edema; Sophia C Woolley; Guido Benedetti; Rafael Van Den Bergh; Miguel Trelles Journal: BMC Emerg Med Date: 2019-10-18