Role of Tranexamic Acid in Controlling Blood Loss in Hemiarthroplasty of the Hip: A Prospective and Observational Study

TL;DR

This study shows that tranexamic acid helps reduce blood loss and transfusion needs in hip hemiarthroplasty surgery.

Contribution

The study is one of the first to evaluate tranexamic acid's efficacy in hip hemiarthroplasty, a less-researched surgical context.

Findings

Patients receiving tranexamic acid had a significant reduction in postoperative hemoglobin drop.

Tranexamic acid reduced the need for postoperative blood transfusions.

Total drain output was lower in patients given tranexamic acid.

Abstract

Introduction: Tranexamic acid, an antifibrinolytic drug, is well-established for its efficacy in reducing intraoperative and postoperative blood loss in major orthopedic surgeries, particularly total knee replacement (TKR) and spine surgeries. However, there is limited research on the role of tranexamic acid in hemiarthroplasty of the hip. This study aims to investigate the efficacy of tranexamic acid in controlling blood loss in hemiarthroplasty of the hip.

Objectives: The primary objective was to analyze the pre- and postoperative changes in hemoglobin levels among patients undergoing hemiarthroplasty of the hip with and without intravenous tranexamic acid administration.

Methods: A prospective observational study was conducted at the Department of Orthopedics of Government Medical College, Kannur, and St. Joseph’s Hospital, Karuvanchal, Kannur. Patients undergoing hemiarthroplasty of the hip with 1 gm of intravenous tranexamic acid were compared with those without tranexamic acid. The sample size was calculated to be 33 in each group. Data were collected using a standardized proforma, entered into an Excel sheet (Redmond, USA), and analyzed using IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.

Results: The study comprised mainly elderly females with a mean age of 74.84 ± 8 years. There was a significant reduction in postoperative hemoglobin drop, requirement for postoperative blood transfusion, and total drain output for the initial three postoperative days among patients who received intravenous tranexamic acid.

Conclusion: Preoperative administration of intravenous tranexamic acid significantly reduced postoperative hemoglobin drop and the need for postoperative blood transfusion in patients undergoing hemiarthroplasty of the hip. This highlights the efficacy and safety of tranexamic acid in controlling blood loss in this surgical setting.

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