Tranexamic acid lowers transfusion requirements and hospital length of stay following revision total hip or knee arthroplasty

Patient Safety in Surgery

Bishoy N. Saad¹  Frank A. Liporace¹  Richard S. Yoon¹  Luke G. Menken¹  Sherif Elkattaway¹  Arianna L. Gianakos²  Richard Haring³ 

[1] Divison of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, City Medical Center-RWJBarnabas Health, 377 Jersey Ave, Suite 280A, 07302, Jersey City, NJ, USA;Harvard-Massachusetts General Hospital, Boston, Massachusetts, USA;Vanderbilt University Medical Center, Nashville, Tennessee, USA;

关键词: Tranexamic acid;    TXA;    Revision total hip arthroplasty;    THA;    Revision total knee arthroplasty, blood conservation;    TKA;   

DOI  :  10.1186/s13037-021-00295-5

来源: Springer

【 摘 要 】

BackgroudIntravenous tranexamic acid (TXA) has been shown to reduce blood loss in patients undergoing total joint arthroplasty without systemic complications. There is limited evidence of its effectiveness in revision procedures. This study evaluated intravenous TXA effect on blood loss, transfusion rates, and length of hospital stay in revision joint replacement.MethodsOne-hundred revision total joint arthroplasty patients were retrospectively reviewed [44 revision total hip arthroplasty (THA) and 54 revision total knee arthroplasty (TKA)] who underwent surgery from 2013 to 2016. Fifty-four revision joint patients (23 THA and 31 TKA) received intravenous TXA intra-operatively, while 46 revision joint patients (23 THA/TKA) did not. Primary outcome measures were blood loss, transfusion rates, and length of hospital stay.ResultsThe mean blood loss difference between revision THA patients who received TXA vs. not receiving TXA was 180ml in revision THA patients (p < .005). Mean length of hospital stay was 6 days in non-TXA vs. 3 days in TXA patients (p < .001). Eighteen patients received transfusions in the non-TXA revision TKA group compared to nine patients in the TXA revision TKA group (p < .001). Average length of hospital stay was 5 days in the non-TXA revision TKA group compared to 3 days in the TXA revision TKA group (p < .003). There was no increased risk of thromboembolic complications in TXA groups for either procedure.ConclusionsIntravenous TXA reduced length of hospital stay in both revision cohorts, decreased blood loss in revision THA and decreased the rate of transfusion in revision TKA without an increase in thromboembolic complications.Level of EvidenceLevel III (Case-control study)

【 授权许可】

CC BY