Objectives: Evaluate differences between blood transfusion and complication rates among fragility hip fracture patients treated with locally injected (Local) versus intravenous (IV) tranexamic acid (TXA).
Methods: Design: Retrospective comparative cohort.
Setting: Tertiary referral orthopaedic specialty hospital; Level I trauma center.
Patient Selection Criteria: Patients aged 50 years and over who underwent surgical treatment for a proximal femur fragility fracture (Orthopedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen 31A and 31B). Between March 2018 and April 2022 with or without the use of local TXA during wound closure or IV TXA.
Outcome Measures And Comparisons: Postoperative blood transfusion, venous thromboembolism, surgical site infections, and 30-day readmissions compared between those who received IV TXA, Local TXA, and controls that did not receive any TXA.
Results: Seven hundred forty-six patients (258 received IV TXA, 252 received Local TXA, and 236 controls that did not receive any TXA) were studied. Both Local and IV TXA groups received fewer blood transfusion versus controls. IV TXA was associated with a transfusion rate reduction of 12% compared with Local TXA ( P < 0.001). Regression analysis indicated that IV TXA reduced the odds of a postoperative blood transfusion by 48% compared with Local TXA ( P = 0.017). There were no differences in complication rates among the groups; however, patients receiving IV TXA had a significantly lower 30-day readmission rate (5%) than the control (13.9%) or Local (13.8%) TXA groups ( P = 0.001).
Conclusions: IV TXA significantly reduced the risk of postoperative transfusion compared with controls and patients receiving Local TXA. There was no increased risk of complications, and a lower 30-day readmission was observed for the IV TXA group. IV TXA seems to be a safe and effective way to reduce postoperative blood transfusion in patients with fragility hip fractures.
Level Of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BOT.0000000000002737 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Impact of Tranexamic Acid Administration in Reduction Mammaplasty: A Systematic Review.
Ann Plast Surg
December 2024
Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, São João University Hospital, Porto, Portugal.
Background: Previous studies demonstrated the effectiveness and safety of tranexamic acid (TXA) in several surgical specialties. Recent publications suggested that TXA may also be beneficial in plastic surgery, including breast procedures.
Objective: The aim of this study is to evaluate the impact of TXA in reduction mammaplasty by assessing several intraoperative and postoperative outcomes and the safety of its administration.
Postpartum Hemorrhage in Humanitarian Settings: Implementation Insights from Using Heat-Stable Carbetocin and Tranexamic Acid.
Int J MCH AIDS
September 2024
United Nations Population Fund, Humanitarian Response Division, Switzerland.
Article Synopsis
- Maternal mortality due to postpartum hemorrhage (PPH) is a significant issue in low-resource settings, and this study examines healthcare providers' perspectives on the effectiveness and challenges of using heat-stable carbetocin (HSC) and tranexamic acid (TXA) for prevention and treatment of PPH.
- The research involved semi-structured interviews and focus group discussions with 64 healthcare workers in South Sudan and Uganda, focusing on a PPH intervention package that included training, readiness kits, and a community support platform.
- Results indicated providers view HSC favorably for preventing bleeding and recognize TXA as effective but noted limited experience with it; challenges included medication confusion and record-keeping issues, while
Advances in the study of nebulized tranexamic acid for pulmonary hemorrhage.
Eur J Clin Pharmacol
February 2025
Department of Cardiology, Bishan Hospital of Chongqing Medical University, Chongqing, China.
Article Synopsis
- Pulmonary hemorrhage is a serious condition that causes blood to leak into the lungs, leading to severe breathing issues, and nebulized tranexamic acid (TXA) shows promise as a treatment option due to its targeted effects and fewer side effects.
- A thorough search of multiple research databases revealed studies on nebulized TXA for pulmonary hemorrhage, including data from two randomized controlled trials, six case series, and nine case reports.
- The findings indicate that nebulized TXA effectively manages bleeding with a dosage of 500 mg/5 ml given 3-4 times daily, showing safety with minimal side effects, mainly local reactions that are easily treated.
Right Drug in the Wrong Place: The Effects of Inadvertent Intrathecal Tranexamic Acid.
Cureus
October 2024
Anesthesiology, Unidade Local de Saúde da Região de Aveiro, Aveiro, PRT.
Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss in major surgeries and trauma patients, thus reducing morbimortality. In recent years, clinical indications for TXA have expanded, including many off-label uses. This broad use has led to an increased incidence of reported side effects and administration errors with serious neurological and cardiovascular outcomes, such as seizures, myoclonus, and arrhythmias.
View Article and Find Full Text PDFTranexamic Acid in Rhytidectomy: A Split-Face Multi-Institutional Study.
Facial Plast Surg Aesthet Med
November 2024
Hamilton Facial Plastic Surgery, Greenwood, Indiana, USA.
Tranexamic acid (TXA) has the ability to reduce intraoperative bleeding and facilitate hemostasis in addition to its anti-inflammatory properties that can potentially aid in recovery among patients who underwent rhytidectomy. To compare postoperative ecchymosis in patients who underwent rhytidectomy with TXA added to the tumescent anesthetic. A multi-institutional, single-blind study was performed on patients who underwent rhytidectomy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!