Perioperative Tranexamic Acid Treatment and Risk of Cardiovascular Events or Death After Total Hip Arthroplasty

Dastrup, Alexander; Pottegård, Anton; Hallas, Jesper; Overgaard, Søren

doi:10.2106/jbjs.17.01518

Cited by 18 publications

(18 citation statements)

References 32 publications

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“…IV TXA was not associated with an increased risk of VTE in patients with a history of VTE [22]. Further, a Danish registry study has demonstrated not only a reduced risk of arterial thrombosis (myocardial infarction and ischaemic stroke), but reduced rate of allcause mortality, if TXA is still administered in these patients [24].…”

Section: Discussionmentioning

confidence: 89%

Intravenous versus Intra-Articular Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomised Double Blinded Non-Inferiority Trial

2021

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Introduction Tranexamic acid (TXA) has been shown to be effective in reducing post-operative blood loss after hip replacement surgery. Clinicians can be reluctant to administer intravenous (IV) TXA to high risk patients and intra-articular (IA) administration has been proposed as an alternative mode of delivery. This study was conducted to compare the efficacy of IV versus IA administration of TXA. Methods This prospective, double blinded, randomised non-inferiority trial, compared 69 patients undergoing primary total hip arthroplasty (THA) who received either 3 doses of 15mg/kg of IV TXA or 3 g of IA TXA after capsular closure. The primary outcomes were change in Hb and the rate of blood transfusion. The secondary outcome was the rate of VTE. Results The mean haemoglobin level change from pre-operative to day 1 post-operative for the IV group was 26.7g/L and for IA group was 27.3g/L. No statistically significant difference was detected between the two groups (p=0.82). No patients required a transfusion or developed a VTE. Conclusions IA administration of TXA can be equally effective as IV in the reduction of blood loss and the prevention of post-operative anaemia in primary THA.

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Section: Discussionmentioning

confidence: 89%

Intravenous versus Intra-Articular Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomised Double Blinded Non-Inferiority Trial

2021

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“…At present, a large number of studies report that TXA is safe and effective in hip and knee joint replacement, regardless of the mode of administration, intravenous, topical, or combination [12][13][14][15]. However, no study has reported on the intravenous infusion of TXA in the acetabulum in terms of its effect on blood loss during the perioperative period in these fractures.…”

Section: Discussionmentioning

confidence: 99%

Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery

Wang¹,

Yang²,

Zhu³

et al. 2020

Preprint

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Backgroud: some studys have reported that topical use of TXA can reduce perioperative blood loss in acetabular fracture surgery. We aim to investigate the effect of intravenous administration of tranexamic acid (TXA) on perioperative blood loss during acetabular fracture surgery Methods From January 2016 to May 2020, 85 patients undergoing surgical treatment with intravenous TXA administration for acetabular fractures at our department were retrospectively analyzed. The patients were divided into three groups according to dosage of TXA: Single treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery (n = 33), repeated treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 h (n = 26), and multiple treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 and 6 h (n = 26). Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, surgery-related transfusion rate, postoperative thrombosis rate, and operation time were compared among these three groups Results Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, and drainage volume in the single treatment group, repeated treatment group, and multiple treatment group were 932.7.0 ± 181.8 ml, 624.2 ± 138.7 ml, 32.2 ± 5.3 g/l, and 100.1 ± 30.1 ml; 843.4 ± 153.0 ml, 567.3 ± 144.1 ml, 27.6 ± 3.8 g/l, and 86.1 ± 42.2 ml; and 748.0 ± 145.2 ml, 521.1 ± 98.1 ml, 24.4 ± 4.4 g/l, and 64.8 ± 29.0 ml, respectively; the values were significantly different between groups (P < 0.05). The surgery-related blood transfusion rates in the single treatment, repeated treatment, and multiple treatment groups were 51.5% (17/33), 23.0% (6/26), 19.2% (5/26), respectively. There was no statistically significant difference in surgery-related blood transfusion rates between groups Conclusions Intravenous administration of TXA in acetabular fracture surgery can reduce total blood loss, intraoperative blood loss, and postoperative hemoglobin drop without increasing the risk of venous thrombosis. Multiple administrations before surgery, and at 3 h and 6 h during surgery are more effective than single and repeated administration

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Section: Discussionmentioning

confidence: 99%

Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery

Wang

Yang

et al. 2019

Preprint

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Backgroud:Literature have reported that topical use of TXA can reduce perioperative blood loss in acetabular fracture surgery.We aim to investigate the effect of intravenous administration of tranexamic acid (TXA) on perioperative blood loss during acetabular fracture surgery Methods:From January 2016 to October 2019, 85 patients undergoing surgical treatment with intravenous TXA administration for acetabular fractures at our department were retrospectively analyzed. The patients were divided into three groups according to dosage of TXA: Single treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery (n = 33), repeated treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 h (n = 26), and multiple treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 and 6 h (n = 26). Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, surgery-related transfusion rate, postoperative thrombosis rate, and operation time were compared among these three groups Results:Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, and drainage volume in the single treatment group, repeated treatment group, and multiple treatment group were 932.7.0 ± 181.8 ml, 624.2 ± 138.7 ml, 32.2 ± 5.3 g/l, and 100.1 ± 30.1ml; 843.4 ± 153.0 ml, 567.3 ± 144.1ml, 27.6±3.8 g/l, and 86.1± 42.2 ml; and 748.0 ± 145.2ml, 521.1 ± 98.1ml, 24.4 ± 4.4g/l, and 64.8 ± 29.0 ml, respectively; the values were significantly different between groups (P <0.05). The surgery-related blood transfusion rates in the single treatment, repeated treatment, and multiple treatment groups were 51.5% (17/33), 23.0% (6/26), 19.2% (5/26), respectively. There was no statistically significant difference in surgery-related blood transfusion rates between groups Conclusions:Intravenous administration of TXA in acetabular fracture surgery can reduce total blood loss, intraoperative blood loss, and postoperative hemoglobin drop without increasing the risk of venous thrombosis. Multiple administrations before surgery, and at 3 h and 6 h during surgery are more effective than single and repeated administration

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Perioperative Tranexamic Acid Treatment and Risk of Cardiovascular Events or Death After Total Hip Arthroplasty

Cited by 18 publications

References 32 publications

Intravenous versus Intra-Articular Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomised Double Blinded Non-Inferiority Trial

Intravenous versus Intra-Articular Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomised Double Blinded Non-Inferiority Trial

Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery

Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery

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