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HERO ID
5185420
Reference Type
Journal Article
Title
Efficacy and Safety of Tranexamic Acid for Controlling Bleeding During Surgical Treatment of Intertrochanteric Fragility Fracture with Proximal Femoral Nail Anti-rotation: A Randomized Controlled Trial
Author(s)
Luo, X; He, S; Lin, Z; Li, Z; Huang, C; Li, Q
Year
2019
Is Peer Reviewed?
Yes
Journal
Indian Journal of Orthopaedics
ISSN:
0019-5413
Volume
53
Issue
2
Page Numbers
263-269
Language
English
PMID
30967695
DOI
10.4103/ortho.IJOrtho_401_17
Web of Science Id
WOS:000459979900008
Abstract
Background:
Intertrochanteric fragility fracture (IFF) treated with proximal femoral nail anti-rotation (PFNA) is associated with significant hidden blood loss and high blood transfusion rate. The purpose of the present study was to evaluate the efficacy and safety of tranexamic acid (TXA) in reducing blood loss in these patients.
Materials and Methods:
Consecutive eligible patients were recruited and randomly assigned to a TXA group or a control group. The TXA group received 15 mg/kg body weight of TXA intravenously 15 min before incision and the same dose 3 h later. The control group received 100 mL of saline intravenously 15 min before incision. The efficacy outcomes included the total perioperative blood loss, postoperative transfusion rate, postoperative hemoglobin level, and length of the hospital stay. The safety outcomes were the incidence of thrombotic events and the mortality rate within 6 weeks after surgery.
Results:
We had 44 patients in the TXA group and 46 patients in the control group for the final analysis. The TXA group had significantly lower total perioperative blood loss than the control group (384.5 ± 366.3 mL vs. 566.2 ± 361.5 mL; P < 0.020). Postoperative transfusion rate was 15.9% in the TXA group versus 36.9% in the control group (P = 0.024). Each group had one patient with postoperative deep venous thrombosis. In the control group, three patients had cerebral infarction, and one patient died within 6 weeks after the operation.
Conclusion:
Intravenous TXA is effective in reducing total perioperative blood loss and transfusion rate in IFF treated with PFNA. No increased risk of thrombotic events was observed with the use of TXA; however, this study was underpowered for detecting this outcome. Further research is necessary before TXA can be recommended for high-risk patients.
Tags
PFAS
•
Additional PFAS (formerly XAgency)
•
PFAS 150
Literature Search August 2019
PubMed
Web of Science
Not prioritized for screening
Perfluorononanoic acid
•
PFNA
Literature Search
Pubmed
WOS
PFNA May 2019 Update
Pubmed
Web of Science
LitSearch: May 2019 - May 2020
WoS
Title and Abstract Screening
Excluded
Not relevant to PECO
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