title: Venous thromboembolism and mortality associated with tranexamic acid use during total hip and knee arthroplasty.
abstract: TKA and THA are associated with blood transfusion and risk for postoperative venothromboembolism (VTE). Reports show that tranexamic acid (TA) may be safe to use in high-risk orthopedic patients, but further data are needed to substantiate its use. All patients who underwent primary or revision TKA or THA in a five year period were retrospectively identified. In 13,262 elective TKA or THA procedures, neither the odds of VTE (OR=0.98; 95% CI 0.67-1.45; P=0.939) or adjusted odds of death (OR=0.26; 95% CI 0.04-1.80; P=0.171) were significant with TA administration. The major findings of this large, single center, retrospective cohort study show the odds of postoperative VTE and 30-day mortality were unchanged with TA administration.
authors.affiliation: Department of Anesthesia, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Duncan
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Blake P
authors.initials: BP
authors.lastname: Gillette
authors.affiliation: Department of Anesthesia, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Adam K
authors.initials: AK
authors.lastname: Jacob
authors.affiliation: Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Sierra
authors.affiliation: Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Sanchez-Sotelo
authors.affiliation: Department of Anesthesia, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Hugh M
authors.initials: HM
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: hip arthroplasty; knee arthroplasty; mortality; tranexamic acid; venothromboembolism