title: Impact of Tranexamic Acid in Total Knee and Total Hip Replacement.
abstract: OBJECTIVE
  To evaluate the net clinical benefit of tranexamic acid use in patients undergoing total knee or total hip replacement.
  
  
  METHODS
  This is a retrospective study of patients undergoing total knee or total hip replacement. The primary outcome was the net clinical benefit of tranexamic acid use. Secondary outcomes included length of stay, incidence of venous thromboembolism, change in hemoglobin, and number of units of blood transfused.
  
  
  RESULTS
  Four hundred and six patients were screened for inclusion and 327 patients met inclusion criteria; 174 patients received tranexamic acid versus 153 patients who received usual care. Tranexamic acid demonstrated a positive net clinical benefit versus usual care (40.8% vs 13.7%, P < .01) but did not affect length of stay (3.39 vs 3.37 days, respectively, P = .76). Venous thromboembolism was comparable between groups (2.3% vs 0.7%, P = .38). Average change in hemoglobin and need for transfusion were lower in the treatment group versus the usual care group, respectively (3.46 vs 4.26 mg/dL, P < .01).
  
  
  CONCLUSIONS
  Tranexamic acid demonstrated a significant benefit in decreasing change in hemoglobin as well as the need for blood transfusion with no increase in the risk of venous thromboembolism in patients undergoing total knee or total hip replacement.
authors.affiliation: 1 Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: Jaclyn A
authors.initials: JA
authors.lastname: Boyle
authors.affiliation: 1 Northeast Ohio Medical University, Rootstown, OH, USA.|2 Internal Medicine, University Hospitals Geauga Medical Center, Chardon, OH, USA.
authors.forename: Mate M
authors.initials: MM
authors.lastname: Soric
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016022:Case-Control Studies; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000453:epidemiology
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid
keywords: total hip replacement; total knee replacement; tranexamic acid