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Vol. 61. Issue 5.
Pages 289-295 (September - October 2017)
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Vol. 61. Issue 5.
Pages 289-295 (September - October 2017)
Original Article
DOI: 10.1016/j.recote.2017.08.007
Effect of tranexamic acid administration on bleeding in primary total hip arthroplasty
Efecto de dosis única intravenosa de ácido tranexámico sobre el sangrado en artroplastia total de cadera. Estudio prospectivo, controlado y aleatorizado
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A.B. Fernández-Cortiñasa,
Corresponding author
anabelen6k@gmail.com

Corresponding author.
, J.M. Quintáns-Vázqueza, F. Gómez-Suáreza, O. Simón Murilloa, B.R. Sánchez-Lópezb, J.M. Pena-Gracíaa
a Servicio de Cirugía Ortopédica y Traumatología, Hospital COSAGA, Ourense, Spain
b Servicio de Calidad y Estadística, Hospital COSAGA, Ourense, Spain
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Table 1. Description of the sample regarding administration of TXA.
Table 2. Post-surgical drainage levels and Hb (haemoglobin) and Hct (haematocrit). Median [minimum and maximum].
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Abstract
Objective

To study the efficacy of tranexamic acid to decrease perioperative bleeding in patients who have undergone a total hip arthroplasty operation and to evaluate drug safety.

Materials and methods

Observational, prospective, controlled and randomised study on the efficacy of tranexamic acid as a method to reduce bleeding in primary hip replacement surgery. We included 134 patients operated during 2014 in our centre, who were divided into 2 groups according to whether or not they had received tranexamic acid. The main study variables were haemoglobin and haematocrit levels, the amount of blood collected from the post-operative drain in the first 12, 24 and 48h and transfusion requirements.

Results

Post-operative haemoglobin and haematocrit levels were statistically higher (p<0.001) in the group with treatment. During the first 48h bleeding values from the group that did not receive TAX were higher compared to patients treated with tranexamic acid.

Statistically significant differences (p=0.001) were found as to the need for transfusion according to group, more transfusions were performed in the cohort that had not received tranexamic acid: 25.37% compared to 4.48% for the group with tranexamic acid.

No adverse events related to administration of tranexamic acid were recorded.

Conclusion

Administration of tranexamic acid has proved to be an effective and safe method to reduce peri-operative bleeding in patients who underwent total hip arthroplasty and avoids allogenic blood transfusion. Therefore, tranexamic acid treatment could entail a financial saving for the healthcare system and expose the patient to less risk.

Keywords:
Tranexamic acid
Total hip arthroplasty
Bleeding
Transfusion
Resumen
Objetivo

Estudiar la efectividad del ácido tranexámico como método para disminuir el sangrado perioperatorio en pacientes intervenidos de artroplastia total primaria de cadera, así como su seguridad.

Material y métodos

Estudio prospectivo, aleatorizado y controlado sobre la eficacia del ácido tranexámico como método para disminuir el sangrado en cirugía protésica primaria de cadera. Se han incluido 134 pacientes intervenidos durante el año 2014 en nuestro centro, los cuales se han dividido en 2 grupos según se le ha administrado o no ácido tranexámico. Las variables principales del estudio fueron los niveles de hemoglobina y hematocrito posquirúrgicos a las 24horas, la cantidad de sangre recogida en el drenaje postoperatorio a las 12, 24 y 48horas, así como las necesidades transfusionales.

Resultados

Los niveles de hemoglobina y hematocrito posquirúrgicos fueron estadísticamente superiores (p<0,001) en el grupo al que se le administró ácido tranexámico. En las primeras 48horas los valores de sangrado del grupo control fueron mayores con respecto a los pacientes tratados con ácido tranexámico.

Se encontraron diferencias estadísticamente significativas (p=0,001) en cuanto a la necesidad de transfusión en función del grupo, siendo superior en el grupo control (25,37% frente a 4,48% del grupo tratado).

No se registraron eventos adversos relacionados con la administración de ácido tranexámico.

Conclusiones

La administración de ácido tranexámico ha demostrado ser un método efectivo y seguro para disminuir el sangrado perioperatorio en pacientes intervenidos de artroplastia total primaria de cadera, y así disminuir las necesidades transfusionales.

Palabras clave:
Ácido tranexámico
Artroplastia total de cadera
Sangrado
Transfusión

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