One step closer to sparing total blood loss and transfusion rate in total knee arthroplasty: a meta-analysis of different methods of tranexamic acid administration

Shemshaki, Hamidreza; Nourian, Sayed Mohammad Amin; Nourian, Niloofaralsadat; Dehghani, Masoudhatef; Mokhtari, Masoud; Mazoochian, Farhad

doi:10.1007/s00402-015-2189-7

Cited by 54 publications

(39 citation statements)

References 55 publications

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“…Topical (intra-articular) and systemic (IV) TXA as the most routinely used single dose regimens have been shown to be safe and effective. 4,5,9,10 Recent RCTs have generally reported that IV and topical regimens had similar efficiency, 1,4,11 whereas a recent study concluded that the topical regimen seemed to be more effective. 6 After many studies evaluating and comparing the single regimens, combined regimens (IV þ topical) started to be investigated with the aim of The values are given as the mean + standard deviation.…”

Section: Discussionmentioning

confidence: 99%

The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

Çankaya

Daşar

Satilmis

et al. 2017

J Orthop Surg (Hong Kong)

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Aims: The combined (IV (intravenous) þ topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral þ topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA and whether oral þ topical use is as safe and efficient as the IV þ topical use, in addition to the main advantage of relatively low cost. Methods: In this prospective, randomized study, 100 patients were randomly assigned to either the topical TXA group or the combined (oral þ topical) TXA group. There were no significant differences between the groups in age, body mass index or gender. The haemoglobin and haematocrit levels of each patient were recorded preoperatively and on post-operative days 0, 1, 2 and 3. The post-operative suction drainage and blood transfusion volumes were also recorded. Results: There were statistically significant differences between the groups in haemoglobin and haematocrit levels on post-operative days 0, 1, 2 and 3 (p < 0.05) in favour of the combined group. The post-operative drainage amounts (p ¼ 0.0001), measured blood loss volume (p ¼ 0.003) and transfusion rates (p ¼ 0.03) were lower in the combined (oral þ topical) group compared to the topical group. Conclusions: Of the different methods of TXA administration, the combined use of oral and topical TXA is a safe, efficient and low-cost method in reducing blood loss and transfusion rates after TKA.

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Section: Discussionmentioning

confidence: 99%

The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

Çankaya

Daşar

Satilmis

et al. 2017

J Orthop Surg (Hong Kong)

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“…In contrast to the advances in knowledge of patient blood management, efforts to reduce blood transfusion have improved in clinical practice. In addition, various methods to reduce transfusion have been attempted in hip arthroplasty recently, with a high percentage of patients requiring transfusion during and after the procedures …”

mentioning

confidence: 99%

Transfusion trends in hip arthroplasty in Korea: a nationwide study by the Korean National Health Insurance Service

et al. 2019

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BACKGROUND Hip arthroplasties are strongly associated with blood transfusion to compensate for perioperative bleeding. The purpose of this study was to evaluate the trends in transfusion associated with hip arthroplasties, using nationwide data supplied by the National Health Insurance Service. STUDY DESIGN AND METHODS We used data from nationwide claims database of the Health Insurance Review Assessment Service. The data managed by the National Health Insurance Service were used to identify 161,934 hip arthroplasties under three categories, including bipolar hemiarthroplasty, total hip arthroplasty, and revision arthroplasty, from 2007 to 2015. The transfusion rates, transfusion amounts, the proportion of transfusion, and cost associated with each type of operation were investigated and stratified according to age, sex, hospital type, and region. RESULTS The proportion of patients receiving any allogeneic transfusion was 81.1% in 9 years. The overall proportion of transfusion was 7% fresh frozen plasma, 12% platelets, and 77% RBCs. The average count of transfusions was 4.1 in bipolar hemiarthroplasty (343,815/83,729), 4.3 in total hip arthroplasty (196,869/46,097), and 8.7 in revision arthroplasty (35,044/4,024) from 2007 to 2015. CONCLUSION In this nationally representative study of trends in transfusion associated with hip arthroplasty, we observed significantly high rates of blood transfusion among patients undergoing hip arthroplasties. Although the overall amount of transfusion declined, the allogeneic transfusion rate was still high from 2007 to 2015 in Korea, and higher than other countries are reporting.

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“…Nevertheless, a study that reviewed TKA and THA patients for six weeks, found that over 90% of all lifethreatening complications occurred within 4 days after surgery [5] . Multiple studies, including randomized controlled trials [6][7][8][9] and meta-analyses [10][11][12][13][14] have found the same promising results on the effectiveness of TXA. In accordance with our research, multiple other studies have been underpowered to detect a difference in VTE rates.…”

Section: Discussionmentioning

confidence: 84%

Tranexamic Acid Use in the Total Hip and Total Knee Arthroplasty Population at an Academic Medical Center: a Retrospective Review of Postoperative Outcomes

Kaufman¹,

Murphy²,

Tuttle³

et al. 2017

IOSRJPBS

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One step closer to sparing total blood loss and transfusion rate in total knee arthroplasty: a meta-analysis of different methods of tranexamic acid administration

Abstract: This study showed that TXA leads to significant reductions in TBL and the rate of allogeneic transfusions. Generally, no significant difference was detected between IA and IV administration of TXA; however, more studies with focus on safety and efficacy are warranted.

Cited by 54 publications

References 55 publications

The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

Transfusion trends in hip arthroplasty in Korea: a nationwide study by the Korean National Health Insurance Service

Tranexamic Acid Use in the Total Hip and Total Knee Arthroplasty Population at an Academic Medical Center: a Retrospective Review of Postoperative Outcomes

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