The efficiency and safety of intravenous tranexamic acid administration in open reduction and internal fixation of pelvic and acetabular fractures

Gümüştaş, Seyit Ali; Çelen, Zekeriya Ersin; Onay, Tolga; Abul, Mehmet Süleyman; Çevi̇k, Hüseyin Bilgehan

doi:10.1007/s00068-021-01624-0

Cited by 7 publications

(13 citation statements)

References 45 publications

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“…By countering fibrinolysis during this peak interval, the use of TXA perioperatively can help to inhibit the activation of plasmin and effectively reduce blood loss. TXA has already proven to reduce blood loss in many orthopedic surgeries, which include knee arthroplasty [ 8 , 9 ], humeral fractures [ 10 ] as well as pelvic and acetabular fractures [ 11 , 12 ]. Importantly, previous meta-analyses have explored the safety of TXA in total hip arthroplasties and have shown to reduce allogeneic transfusion rates [ 13 ], decrease total and intraoperative blood loss [ 14 ] as well as lower postoperative hemoglobin decline [ 15 ], when compared to the placebo.…”

Section: Introductionmentioning

confidence: 99%

Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis

Miangul

Oluwaremi

Haddad

et al. 2022

Eur J Orthop Surg Traumatol

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Aim The aim of this meta-analysis was to assess the safety and efficacy of tranexamic acid (TXA) in the management of hip fracture surgeries in comparison with placebo. Methods A systematic search was conducted from August 6, 2021. Eligible studies included randomized clinical trials and prospective studies comparing the use of intravenous TXA in patients treated for hip fractures, in comparison with placebo. Review Manager was used for the meta-analysis. Results Eighteen prospective studies including 14 RCTs met the eligibility criteria. The results favored the TXA group in the quantity of total blood loss (MD = − 196.91 mL, 95% CI − 247.59, − 146.23, I2 = 92%), intraoperative blood loss (MD = − 26.86 mL, 95% CI − 36.96, − 16.78, I2 = 62%), and rate of blood transfusion (OR 0.35, 95% CI 0.28, 0.42, I2 = 0%). TXA also exhibited higher hemoglobin level at day 1 (MD = 6.77 g/L, 95% CI 4.30, 9.24, I2 = 83%) and day 3 (MD = 7.02 g/L, 95% CI 3.30, 10.74, I2 = 82%) postoperatively. There was no significant difference found in the incidence of thromboembolic events from occurring between the two groups, such as deep vein thrombosis (OR 1.22, 95% CI 0.73, 2.02, I2 = 0%) and pulmonary embolism (OR 0.82, 95% CI 0.33, 2.05, I2 = 0%). Conclusion Administration of intravenous TXA appears to reduce blood loss, rate of blood transfusions and pose no increased risk of thromboembolic events. Therefore, TXA should be considered by physicians when managing hip fracture patients. Graphical abstract

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Section: Introductionmentioning

confidence: 99%

Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis

Miangul

Oluwaremi

Haddad

et al. 2022

Eur J Orthop Surg Traumatol

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“…In the study by Gumustas et al [ 18 ], there were no reported cases of DVT. In the study by Wadhwa et al [ 8 ], there was a proportionally higher rate of DVT in the control group compared to TXA (2.8% vs 1.1%) however this was not statistically significant.…”

Section: Reviewmentioning

confidence: 99%

“…The average incidence of DVT was 2.8% in the TXA group and 1.7% in the control group (p=0.097) as demonstrated in Table 11 . The study by Gumustas et al [ 18 ] did not have any reported cases of DVT. The study by Wadhwa et al [ 8 ] had a higher incidence of DVT in the control group in comparison to the TXA group.…”

Section: Introductionmentioning

confidence: 99%

“…Utilising the GRADE assessment tool, the RCTs were noted to be well-designed with a low risk of individual biases as demonstrated in Table 5 . For the non-RCTs, utilising the MINORS assessment tool, it was noted that individual elements were missing in the studies conducted by Cohen et al [ 17 ] and Gumustas et al [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the context of EBL, in the study by Cohen-Levy et al [ 17 ], the EBL was not explicitly documented. In the study by Gumustas et al [ 18 ], a comparative analysis could not be undertaken as there was no control group. In the analysis of the remaining three studies, the mean EBL in the TXA group was noted to be higher when compared to the placebo group (mean - 850mL vs 661mL) (p=0.49) as demonstrated in Table 8 and Figure 2 .…”

Section: Introductionmentioning

confidence: 99%

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To Assess the Outcomes Associated With the Use of Tranexamic Acid in the Open Fixation of Pelvic and Acetabular Fractures

Chowdhury¹

2023

Cureus

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There is a growing knowledge base for the use of antifibrinolytic therapy in trauma and orthopaedic surgery. The mechanism of action of tranexamic acid (TXA) is through the inhibition of fibrinolysis. The role of TXA in hip fractures has been researched extensively. However, the research has been limited to the cases of pelvic and acetabular fractures. This systematic review aimed to examine the effect of TXA on patients undergoing open pelvic and acetabular fracture surgery. The primary goal of the study was to examine the estimated blood loss (EBL) and blood transfusion rates in patients who received TXA versus those who did not receive TXA. The secondary goal was to examine the rates of deep venous thrombosis (DVT). A literature search was carried out using PubMed, Medline and the Cochrane database. The selection criteria for the systematic review were studies investigating intravenous TXA in the form of randomised controlled trials (RCTs), as well as cohort studies. Five studies were included in the systematic review with 625 total patients. The EBL between the two groups was noted to be 661 mL in the control group and 850 mL in the TXA ( p =0.49). There was a marginally lower number of units transfused in the control group vs the TXA group (1.9 vs 2.2) (p=0.27). The rates of transfusion in the TXA group were 29% TXA whilst, in the control group, it was 31% (p=0.13). The overall incidence of DVT was 2.8% in the TXA group and 1.7% in the control group (p=0.097).

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Is intravenous tranexamic acid effective in reduction of blood loss during pelvic and acetabular surgery?

Sharaby

El-Deeb

2022

International Orthopaedics (SICOT)

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The efficiency and safety of intravenous tranexamic acid administration in open reduction and internal fixation of pelvic and acetabular fractures

Cited by 7 publications

References 45 publications

Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis

Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis

To Assess the Outcomes Associated With the Use of Tranexamic Acid in the Open Fixation of Pelvic and Acetabular Fractures

Is intravenous tranexamic acid effective in reduction of blood loss during pelvic and acetabular surgery?

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