Tranexamic Acid Aids Outcomes in Orthopedic Surgery
(HealthDay News) — The clotting drug tranexamic acid is effective in reducing the need for blood transfusions while not increasing the risk of complications during orthopedic surgery, according to a study published online August 12 in BMJ.
Jashvant Poeran, PhD, from the School of Medicine at Mount Sinai in New York City, and colleagues analyzed data from 510 U.S. hospitals using the claims-based Premier Perspective database (2006–2012) to identify 872,416 patients who had total hip or knee arthroplasty. Perioperative intravenous tranexamic acid use was categorized by dose (none, ≤1,000mg, 2,000mg, and ≥3,000mg) and subsequent outcomes were evaluated.
The researchers found that patients receiving tranexamic acid showed lower rates of allogeneic or autologous transfusion (7.7 vs. 20.1%), thromboembolic complications (0.6 vs. 0.8%), acute renal failure (1.2 vs. 1.6%), and combined complications (1.9 vs. 2.6%) (all P<0.01), compared to those not receiving it. In models examining tranexamic acid dose categories there were significant associations (P<0.001) for decreased odds for allogeneic or autologous blood transfusions (odds ratio [OR], 0.31–0.38 by dose category) but no significantly increased risk for complications (thromboembolic complications: OR, 0.85–1.02; acute renal failure: OR, 0.70–1.11; and combined complications: OR, 0.75–0.98).
"Thus our data provide incremental evidence of the potential effectiveness and safety of tranexamic acid in patients requiring orthopedic surgery," the authors write.