title: Economic impact of tranexamic acid in healthy patients undergoing primary total hip and knee arthroplasty.
abstract: Tranexamic acid (TA) has been shown to reduce perioperative blood loss and blood transfusion. While concern remains about the cost of antifibrinolytic medication, we hypothesized that routine use of tranexamic acid would result in lower direct hospital total cost by decreasing costs associated with blood transfusion, laboratory testing, and room & board. Patients with an American Society of Anesthesiologists (ASA) class II or less undergoing primary total hip or knee arthroplasty at a single institution during 2007-2008 were retrospectively reviewed. The estimated mean direct hospital total cost, operating room, blood/lab, room & board, and pharmacy costs were compared between patients who did and did not receive TA. The study population included 1018 patients, and 580 patients received TA. The mean direct total cost of hospitalization with and without TA was $15,099 and $15,978 (P<.0002) respectively, a difference of $879. The only increased cost associated with TA was the pharmacy cost which was $921 versus $781 (P<.0001). The routine use of tranexamic acid TA was associated with lower mean direct hospital total costs after primary total hip and knee arthroplasty as the increase in pharmacy costs was more than offset by cost savings in other categories.
authors.forename: Blake P
authors.initials: BP
authors.lastname: Gillette
authors.forename: Hilal
authors.initials: H
authors.lastname: Maradit Kremers
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Duncan
authors.forename: Hugh M
authors.initials: HM
authors.lastname: Smith
authors.forename: Robert T
authors.initials: RT
authors.lastname: Trousdale
authors.forename: Mark W
authors.initials: MW
authors.lastname: Pagnano
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Sierra
mesh_terms: D000933:Antifibrinolytic Agents / Q000191:economics / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000191:economics; D015331:Cohort Studies; D003363:Cost Control / Q000191:economics; D017046:Cost Savings / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008875:Middle Aged; D010607:Pharmacy Service, Hospital / Q000191:economics; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: economic impact; hip and knee arthroplasty; tranexamic acid