title: Effect of Single Preoperative Dose of Tranexamic Acid on Blood Loss and Transfusion in Hip Arthroplasty.
abstract: BACKGROUND
  The aim of the study was to assess the effect of a single intravenous dose of tranexamic acid administered before surgery in patients undergoing total cementless hip arthroplasty on: intra-, post-, and perioperative blood lost, the number of patients requiring transfusion, the incidence of thromboembolic complications Material and methods. The study enrolled 124 patients, who were randomly divided into two groups. The experimental group (61 patients) received an intravenous dose of 15 mg/kg of tranexamic acid 20 minutes before the skin incision, while the control group (63 patients) did not receive this drug. We analysed intraoperative blood loss (volume of blood in the aspirator), postoperative blood loss (volume of blood drained), total perioperative blood loss, and the number of patients requiring transfusion as well as the number of thromboembolic complications in both groups.
  
  
  RESULTS
  In the experimental group, mean intraoperative blood loss was significantly lower at 216 ml compared to 408.5 ml in the control group (p=0.00421). Postoperative blood loss on the first postoperative day was also lower in the experimental group (246.3 ml) as compared with the control group (358 ml, p=0.000097). Estimated perioperative blood loss in the experimental group was lower as well, reaching 779 ml, vs. 1315.5 ml in the control group (p=0.00567). The percentage of patients requiring transfusion in the experimental group (3.27%) was significantly lower than in the control group (22.22%) (p=0.00166). The use of tranexamic acid did not influence the number of thromboembolic complications (p=0.3075).
  
  
  CONCLUSIONS
  1. The administration of 15 mg/kg of tranexamic acid 20 minutes before surgery decreases the need for postoperative transfusion of allogeneic blood due to a significant reduction in intra-, post-, and perioperative blood loss. 2. Seeing that this method does not increase the number of thromboembolic complications and is simple and inexpensive, it should be considered worthy of recommendation in total cementless hip arthroplasty.
authors.affiliation: Department V of Trauma and Orthopaedic Surgery, A. Sokołowski Specialist Hospital, Szczecin Zdunowo, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Jaszczyk
authors.affiliation: Department V of Trauma and Orthopaedic Surgery, A. Sokołowski Specialist Hospital, Szczecin Zdunowo, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kozerawski
authors.affiliation: University and Hospital Department of Orthopaedics, Traumatology, and Oncology of the Musculoskeletal System, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kołodziej
authors.affiliation: Department of Vascular Surgery, General Surgery, and Angiology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Kazimierczak
authors.affiliation: Department V of Trauma and Orthopaedic Surgery, A. Sokołowski Specialist Hospital, Szczecin Zdunowo, Poland.
authors.forename: Patryk
authors.initials: P
authors.lastname: Sarnecki
authors.affiliation: University and Hospital Department of Orthopaedics, Traumatology, and Oncology of the Musculoskeletal System, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Sieczka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D013923:Thromboembolism / Q000517:prevention & control*; D014148:Tranexamic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid