title: The Use of Intravenous Tranexamic Acid in Patients Undergoing Total Hip or Knee Arthroplasty: A Retrospective Analysis at a Single Military Institution.
abstract: OBJECTIVE
  To describe a single institution's experience after initiation of a protocol in which all primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients were administered intravenous tranexamic acid (TXA) intraoperatively to decrease perioperative blood loss.
  
  
  METHODS
  A retrospective review of medical records at a single institution from February 2012 to April 2014. The TXA treatment group was compared to a control group. We reviewed intraoperative blood loss, preoperative hemoglobin (Hb) levels, postoperative day 0 to 2 Hb levels, transfusion rates, postoperative venous thromboembolism, and other complication rates.
  
  
  RESULTS
  259 patients underwent either TKA (165) or THA (94). 121 received perioperative intravenous TXA and 138 did not. There was a statistically decreased rate of allogeneic blood transfusion (0 vs. 10, p = 0.003) as well as a higher postoperative day 2 Hb level (10.8 ± 1.1 vs. 10.2 ± 2.6 g/dL, p = 0.02) in the treatment group. There was no statistical difference in any variable measured in the THA group, though there was a trend toward higher postoperative Hb levels at all-time points measured.
  
  
  CONCLUSIONS
  Intravenous TXA is a safe and effective drug to decrease perioperative blood loss and allogeneic transfusion in THA and TKA. There was no increased risk of venous thromboembolism or other complications in our review.
authors.affiliation: Walter Reed National Military Medical Center, America Building, Room 2010, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Formby
authors.affiliation: Walter Reed National Military Medical Center, America Building, Room 2010, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Pickett
authors.affiliation: Walter Reed National Military Medical Center, America Building, Room 2010, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Van Blarcum
authors.affiliation: Walter Reed National Military Medical Center, America Building, Room 2010, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Mack
authors.affiliation: Walter Reed National Military Medical Center, America Building, Room 2010, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Newman
mesh_terms: D061605:Administration, Intravenous; D000933:Antifibrinolytic Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid