Effect and safety of topical application of tranexamic acid to reduce perioperative blood loss in elderly patients with intertrochanteric fracture undergoing PFNA

Abstract Background: The specific method and dose of tranexamic acid (TXA) topically applied in intertrochanteric fracture have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically treated by our protocol in perioperative bleeding management for elderly patients with intertrochanteric fracture treated undergoing proximal femoral nail anti-rotation (PFNA). Methods: A retrospective comparative analysis was performed. Group TXA was comprised of 82 patients with topical use of TXA and group control was comprised of 82 patients without TXA during the procedure of PFNA. Intraoperative, total and hidden blood loss, drainage volume, postoperative blood transfusion volume and complications were compared between the two groups. Results: Intraoperative, total and hidden blood loss, and drainage volume were significantly lower in the TXA group than those in the control group (P=0.012, P<0.01, P<0.01, P=0.014, respectively). The volume and rate of blood transfusion in TXA group were significantly lower than those in the control group (P<0.01). There were no significant differences in complications between two groups (P>0.05). Conclusion: Topical application of TXA offers an effective and safe option in reducing perioperative blood loss and transfusion for elderly patients with intertrochanteric fractures undergoing PFNA.

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Effect and safety of topical application of tranexamic acid to reduce perioperative blood loss in elderly patients with intertrochanteric fracture undergoing PFNA

10.21203/rs.2.21728/v2 ◽

2020 ◽

Author(s):

Huiping Wei ◽

Qiuping Xiao ◽

Jianfeng He ◽

Tianji Huang ◽

Wantang Xu ◽

...

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Elderly Patients ◽

Tranexamic Acid ◽

Topical Application ◽

Control Group ◽

Specific Method ◽

Intertrochanteric Fractures ◽

Perioperative Blood Loss ◽

Perioperative Bleeding

Abstract Background: The specific method and dose of tranexamic acid (TXA) topically applied for intertrochanteric fractures have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically administered via our protocol for perioperative bleeding management in elderly patients with intertrochanteric fractures who underwent proximal femoral nail anti-rotation (PFNA).Methods: A retrospective comparative analysis was performed. The TXA group was composed of 82 patients with topical use of TXA, and the control group was composed of 82 patients without TXA use during the PFNA procedure. Intraoperative, total and hidden amounts of blood loss, drainage volumes, postoperative blood transfusion volumes and complications were compared between the two groups.Results: The intraoperative, total and hidden amounts of blood loss and the drainage volumes were significantly lower in the TXA group than in the control group (P=0.012, P<0.01, P<0.01, P=0.014, respectively). The volume and rate of blood transfusion in the TXA group were significantly lower than those in the control group (P<0.01). There were no significant differences in complications between the two groups (P>0.05).Conclusion: Topical application of TXA offers an effective and safe option for reducing perioperative blood loss and transfusion in elderly patients with intertrochanteric fractures undergoing PFNA.

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Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02166-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Huixu Ma ◽

Hairuo Wang ◽

Xiaotao Long ◽

Zexiang Xu ◽

Xiaohua Chen ◽

...

Keyword(s):

Blood Loss ◽

Elderly Patients ◽

Tranexamic Acid ◽

Venous Thrombosis ◽

Intertrochanteric Fracture ◽

Transfusion Rate ◽

Intertrochanteric Fractures ◽

Randomized Controlled ◽

Hidden Blood Loss ◽

Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture. Methods A prospective randomized controlled study was conducted with 125 patients (age ≥ 65 years, injury time ≤ 6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n = 63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n = 62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic days (PTDs) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis. Results Hgb on PTDs 2 and 3 was statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1–3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications. Conclusion Early IV TXA intervention could reduce post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

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Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

10.21203/rs.3.rs-28525/v1 ◽

2020 ◽

Author(s):

Hui Xu Ma ◽

Hairuo Wang ◽

Xiaotao Long ◽

Zexiang Xu ◽

Xiaohua Chen ◽

...

Keyword(s):

Blood Loss ◽

Elderly Patients ◽

Tranexamic Acid ◽

Venous Thrombosis ◽

Intertrochanteric Fracture ◽

Transfusion Rate ◽

Intertrochanteric Fractures ◽

Randomized Controlled ◽

Hidden Blood Loss ◽

Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group than in the NS group. Preoperative transfusion rate was significantly lower in the TXA group than in the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

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Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

10.21203/rs.3.rs-28525/v2 ◽

2020 ◽

Author(s):

Hui Xu Ma ◽

Hairuo Wang ◽

Xiaotao Long ◽

Zexiang Xu ◽

Xiaohua Chen ◽

...

Keyword(s):

Blood Loss ◽

Elderly Patients ◽

Tranexamic Acid ◽

Venous Thrombosis ◽

Intertrochanteric Fracture ◽

Transfusion Rate ◽

Intertrochanteric Fractures ◽

Randomized Controlled ◽

Hidden Blood Loss ◽

Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

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Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

10.21203/rs.3.rs-28525/v3 ◽

2020 ◽

Author(s):

Hui Xu Ma ◽

Hairuo Wang ◽

Xiaotao Long ◽

Zexiang Xu ◽

Xiaohua Chen ◽

...

Keyword(s):

Blood Loss ◽

Elderly Patients ◽

Tranexamic Acid ◽

Venous Thrombosis ◽

Intertrochanteric Fracture ◽

Transfusion Rate ◽

Intertrochanteric Fractures ◽

Randomized Controlled ◽

Hidden Blood Loss ◽

Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

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