The use of tranexamic acid to reduce blood loss during total hip arthroplasty: an observational study.
BACKGROUND
To test the hypothesis that the fall in haemoglobin following total hip arthroplasty is reduced by tranexamic acid administration.


METHODS
A cohort of 64 patients were studied, 32 received tranexamic acid 20 mg/kg on induction. Surgery was performed by the senior author in a standardised fashion. Haemoglobin levels were measured 2 weeks pre- and 3 days postoperatively. Any complications were noted. The study group was matched using the bone and joint research database for age, sex, procedure, disease and pre-operative haemoglobin level.


RESULTS
In the group receiving no tranexamic acid, the mean fall in haemoglobin was 3.8 g/dl (CI of mean 3.4-4.3) and in the group treated with tranexamic acid 2.8 g/dl (CI of mean 2.5-3.2) P < 0.05. Complications included one non-fatal pulmonary embolus in the tranexamic acid group.


CONCLUSIONS
The administration of 20 mg/kg of tranexamic acid on induction of surgery is an effective method of reducing the haemoglobin fall following hip arthroplasty.
Hynes
M C
MC
Bone and Joint Research Unit, The Royal London Hospital, Whitechapel, London, UK. mchynes@hotmail.com
Calder
P
P
Rosenfeld
P
P
Scott
G
G
D000933:Antifibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D015207:Osteoarthritis, Hip / Q000601:surgery; D011655:Pulmonary Embolism / Q000139:chemically induced; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid