Harry A Demos1, Zilan X Lin1, William R Barfield1, Sylvia H Wilson2, Dawn C Robertson3, Vincent D Pellegrini1. 1. Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina. 2. Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina. 3. Department of Enterprise Analytics, Medical University of South Carolina, Charleston, South Carolina.
Abstract
BACKGROUND: Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. METHODS: After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation. RESULTS: TXA administration increased with project implementation (group A = 3.57%, group B = 86.01%) and was associated with reductions in perioperative hemoglobin decrement (20.2%), patients transfused (45%), and number of units transfused per patient (61.9%). Cost savings were notable per patient ($128) and annually program wide ($55,884) with the primary THA subgroup contributing the most to the savings. No increase in adverse effects was observed. CONCLUSION: Standardized administration of TXA is an effective and economically favorable blood-reduction strategy for patients undergoing elective THA or TKA. Although reduction in transfusions with TXA may be greater after TKA, the economic and clinical impact of transfusion reduction is more substantial in THA patients.
BACKGROUND:Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. METHODS: After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation. RESULTS:TXA administration increased with project implementation (group A = 3.57%, group B = 86.01%) and was associated with reductions in perioperative hemoglobin decrement (20.2%), patients transfused (45%), and number of units transfused per patient (61.9%). Cost savings were notable per patient ($128) and annually program wide ($55,884) with the primary THA subgroup contributing the most to the savings. No increase in adverse effects was observed. CONCLUSION: Standardized administration of TXA is an effective and economically favorable blood-reduction strategy for patients undergoing elective THA or TKA. Although reduction in transfusions with TXA may be greater after TKA, the economic and clinical impact of transfusion reduction is more substantial in THA patients.
Authors: Cyril Pernod; Laurie Fraticelli; Guillaume Marcotte; Bernard Floccard; Thibaut Girardot; Clement Claustre; Carlos El Khoury; Thomas Rimmele Journal: Turk J Anaesthesiol Reanim Date: 2021-10
Authors: Jodie L Morris; Hayley L Letson; Peter McEwen; Erik Biros; Constantin Dlaska; Kaushik Hazratwala; Matthew Wilkinson; Geoffrey P Dobson Journal: J Orthop Surg Res Date: 2021-12-20 Impact factor: 2.359