title: Cost benefit analysis of topical tranexamic acid in primary total hip and knee arthroplasty.
abstract: The purpose of this study was to provide a cost-benefit analysis of topical tranexamic acid (TXA) in primary total hip and knee arthroplasty patients. A retrospective cohort of 591 consecutive patients, 311 experimental and 280 control, revealed a transfusion rate reduction from 17.5% to 5.5%, increased postoperative hemoglobin, and decreased delta hemoglobin without an increase in adverse events (all P < 0.001). This led to saving $83.73 per patient based on transfusion costs alone after accounting for the cost of TXA. Hospital disposition to home compared to subacute nursing facility was also significantly increased by 9.3% (P < 0.02). We conclude that topical TXA reduces transfusion rate, increases home disposition, and reduces cost in primary hip and knee arthroplasty.
authors.affiliation: Department of Orthopaedics, Brown University Alpert School of Medicine, Providence, Rhode Island.
authors.forename: John R
authors.initials: JR
authors.lastname: Tuttle
authors.affiliation: Department of Orthopaedics, Brown University Alpert School of Medicine, Providence, Rhode Island.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Ritterman
authors.affiliation: Department of Orthopaedics, Brown University Alpert School of Medicine, Providence, Rhode Island.
authors.forename: Dale B
authors.initials: DB
authors.lastname: Cassidy
authors.affiliation: Department of Orthopaedics, Brown University Alpert School of Medicine, Providence, Rhode Island.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Anazonwu
authors.affiliation: Department of Orthopaedics, Brown University Alpert School of Medicine, Providence, Rhode Island.
authors.forename: John A
authors.initials: JA
authors.lastname: Froehlich
authors.affiliation: Department of Orthopaedics, Brown University Alpert School of Medicine, Providence, Rhode Island.
authors.forename: Lee E
authors.initials: LE
authors.lastname: Rubin
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000191:economics; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid
keywords: financial; primary arthroplasty; tranexamic acid; transfusion