Itay Ashkenazi1, Haggai Schermann2, Aviram Gold3, Ran Lin2, Itay Pardo2, Ely Steinberg4, Amir Sternheim2, Nimrod Snir2. 1. Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. Electronic address: itay.ashkenazi@gmail.com. 2. Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. 3. Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. Electronic address: aviramg@tlvmc.gov.il. 4. Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. Electronic address: steinberge@tlvmc.gov.il.
Abstract
BACKGROUND: Intraoperative use of tranexamic acid (TXA) has been proven to reduce the administration of allogenic blood transfusion in total joint arthroplasty (TJA) patients. Data on TXA efficacy in reducing blood loss in trauma patients undergoing hip hemiarthroplasty are sparse, and its use is not yet well-established. The purpose of this study was to assess the efficacy and safety of intraoperative TXA use in patients undergoing hip hemiarthroplasty as treatment for intracapsular femoral neck fracture. METHODS: This is a historical cohort of patients who underwent hip hemiarthroplasty in a tertiary medical center between 2011 and 2019, with minimum follow-up of one year. The cohort was divided into one group of patients who received intraoperative TXA treatment and another group that did not. Blood loss, peri‑ and postoperative complications, readmissions, and short- and long-term mortality were compared between groups. RESULTS: Of the 1722 consecutive patients (601 males and 1121 females) who underwent hip hemiarthroplasty who were included in this study, 504 were in the "TXA" group and 1218 were in the "non-TXA" group. TXA use significantly reduced 30-day mortality (4.6% vs 7.3%, respectively, p < 0.046) and perioperative blood loss, as indicated by changes in hemoglobin levels before and after surgery (Δ-1.38 gr/dL vs Δ-1.76 gr/dL, p < 0.001), and by administration of allogenic blood transfusions (17.5% vs 44.4%, p < 0.001). CONCLUSIONS: Similar to the known effect of TXA in TJA patients, the use of TXA treatment in patients undergoing hip hemiarthroplasty led to a significant reduction in 30-day mortality, in postoperative blood loss and in the proportion of patients requiring allogenic blood transfusions.
BACKGROUND: Intraoperative use of tranexamic acid (TXA) has been proven to reduce the administration of allogenic blood transfusion in total joint arthroplasty (TJA) patients. Data on TXA efficacy in reducing blood loss in traumapatients undergoing hip hemiarthroplasty are sparse, and its use is not yet well-established. The purpose of this study was to assess the efficacy and safety of intraoperative TXA use in patients undergoing hip hemiarthroplasty as treatment for intracapsular femoral neck fracture. METHODS: This is a historical cohort of patients who underwent hip hemiarthroplasty in a tertiary medical center between 2011 and 2019, with minimum follow-up of one year. The cohort was divided into one group of patients who received intraoperative TXA treatment and another group that did not. Blood loss, peri‑ and postoperative complications, readmissions, and short- and long-term mortality were compared between groups. RESULTS: Of the 1722 consecutive patients (601 males and 1121 females) who underwent hip hemiarthroplasty who were included in this study, 504 were in the "TXA" group and 1218 were in the "non-TXA" group. TXA use significantly reduced 30-day mortality (4.6% vs 7.3%, respectively, p < 0.046) and perioperative blood loss, as indicated by changes in hemoglobin levels before and after surgery (Δ-1.38 gr/dL vs Δ-1.76 gr/dL, p < 0.001), and by administration of allogenic blood transfusions (17.5% vs 44.4%, p < 0.001). CONCLUSIONS: Similar to the known effect of TXA in TJA patients, the use of TXA treatment in patients undergoing hip hemiarthroplasty led to a significant reduction in 30-day mortality, in postoperative blood loss and in the proportion of patients requiring allogenic blood transfusions.
Authors: Antonio Ziranu; Cesare Meschini; Davide De Marco; Giuseppe Sircana; Maria Serena Oliva; Giusepp Rovere; Andrea Corbingi; Raffaele Vitiello; Giulio Maccauro; Enrico Pola Journal: Orthop Rev (Pavia) Date: 2022-10-13
Authors: Ivan B Stojadinovic; Branko M Ristic; Dragan R Knezevic; Zoran S Milenkovic; Nikola S Prodanovic; Nenad R Zornic; Jelena B Milosevic Journal: Open Med (Wars) Date: 2022-04-29
Authors: Jaroslaw Pecold; Mahdi Al-Jeabory; Maciej Krupowies; Ewa Manka; Adam Smereka; Jerzy Robert Ladny; Lukasz Szarpak Journal: J Clin Med Date: 2021-12-23 Impact factor: 4.241