Johansson, Acta Orthop 2005 - Tranexamic Acid in Total Hip Arthroplasty Saves Blood and Money

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Tranexamic Acid in Total Hip Arthroplasty Saves Blood and Money

Johansson, Lisander, et al.·Acta Orthop·2005·204 citations·RCT

Background

A blood transfusion is a costly transplantation of tissue that may endanger the health for the recipient. Blood transfusions are common after total hip arthroplasty. The total saving potential is substantial if the blood loss could be reduced. Studies on the use of tranexamic acid have shown interesting results, but its benefits in total hip arthroplasty have not yet been resolved.

Methods

100 patients receiving a total hip arthroplasty (THA) got a single injection of tranexamic acid (15 mg/kg) or placebo intravenously before the start of the operation.
The study was double-blind and randomized.
Total blood loss was calculated from the hemoglobin (Hb) balance.
Volume and Hb concentration of the drainage was measured 24 h after the operation.
Intraoperative blood loss was estimated volumetrically and visually.

Results

The patients who received tranexamic acid (TA) bled less.
The total blood loss was on average 0.97 L in the TA group and 1.3 L in the placebo group (p < 0.001).
8/47 (0.2) in the TA group were given blood transfusion versus 23/53 (0.4) in the placebo group (p = 0.009).
Drainage volume and drainage Hb concentration were less in the TA group (p < 0.001 and p = 0.001).
No thromboembolic complications occurred.

Conclusions

Considering the cost of blood and tranexamic acid only, use of the drug would save EUR 47 Euro per patient. We recommend a preoperative single dose of tranexamic acid for standard use in THA.

Copyright remains with the authors and publisher.

Tranexamic Acid in Total Hip Arthroplasty Saves Blood and Money

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Tranexamic Acid in Total Hip Arthroplasty Saves Blood and Money

Johansson, Lisander, et al.·Acta Orthop·2005·204 citations·RCT

Background

A blood transfusion is a costly transplantation of tissue that may endanger the health for the recipient. Blood transfusions are common after total hip arthroplasty. The total saving potential is substantial if the blood loss could be reduced. Studies on the use of tranexamic acid have shown interesting results, but its benefits in total hip arthroplasty have not yet been resolved.

Methods

100 patients receiving a total hip arthroplasty (THA) got a single injection of tranexamic acid (15 mg/kg) or placebo intravenously before the start of the operation.
The study was double-blind and randomized.
Total blood loss was calculated from the hemoglobin (Hb) balance.
Volume and Hb concentration of the drainage was measured 24 h after the operation.
Intraoperative blood loss was estimated volumetrically and visually.

Results

The patients who received tranexamic acid (TA) bled less.
The total blood loss was on average 0.97 L in the TA group and 1.3 L in the placebo group (p < 0.001).
8/47 (0.2) in the TA group were given blood transfusion versus 23/53 (0.4) in the placebo group (p = 0.009).
Drainage volume and drainage Hb concentration were less in the TA group (p < 0.001 and p = 0.001).
No thromboembolic complications occurred.

Conclusions

Considering the cost of blood and tranexamic acid only, use of the drug would save EUR 47 Euro per patient. We recommend a preoperative single dose of tranexamic acid for standard use in THA.

Copyright remains with the authors and publisher.

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