The Use of Antifibrinolytics in Hip Trauma Surgery in a Public Health System: A Prospective Study

Abstract

Objective: To evaluate the use of tranexamic acid (TXA) and ε-aminocaproic acid (EACA) in reducing blood loss in hip and proximal femur trauma surgery. Methods: Prospective study with 49 patients surgically treated in a trauma hospital between Nov/2015 and Feb/2017. The patients were divided in two groups: TXA (n = 24) and EACA (n = 25). The comparison was made according to gender, age at the time of surgery, ASA, fracture and surgery type, estimated blood loss during surgical approach, hemoglobin and hematocrit levels pre and post-operative, and pharmacological cost. The data was processed using SPSS 22.0 with significance level of p < 0,05. Results: No significant difference was found in the variables age, gender, ASA and estimated blood loss during surgical approach. No patient needed blood transfusion. When evaluated post-operatively, the hemoglobin and hematocrit values decrease had no significant difference between the antifibrinolytics (p > 0.05). When analyzing total cost for both pharmacological agents, higher cost was observed in EACA than in TXA (US$ 16.09 - US$ 2.73), resulting in a US$ 13.36 addition per patient. Conclusion: Antifibrinolytic use was efficient on lowering the total blood loss, without the need of blood transfusion. Level of evidence II, Prospective Comparative Study.

A Survey on Enhanced Recovery After Surgery (ERAS) Elements in Cleft Palate Repair

“…10 TXA's use across all surgical specialties is increasing significantly. It has been shown to reduce blood loss in trauma surgery, 12 oral surgery, 13 cardiac surgery, 13 hepatic surgery, 14 and has been shown to minimize pain and reduce drain output in orthopedic surgery. 15 Adverse events such as thromboembolic events secondary to TXA are uncommon, 11 but use has been associated with nausea, vomiting, and diarrhea.…”