title: Tranexamic acid: optimal blood loss management in surface replacement arthroplasty.
abstract: OBJECTIVE
  This study investigated whether the use of tranexamic acid (TXA) decreased blood loss and transfusion related cost following surface replacement arthroplasty (SRA).
  
  
  METHODS
  A retrospective review of patients treated with TXA during a SRA, who did not receive autologous blood (TXA group) was performed. Two comparison groups were established; the first group comprised of patients who donated their own blood pre-operatively (auto group) and the second of patients who did not donate blood pre-operatively (control). Outcomes included transfusions, post-operative haemoglobin (Hgb), complications, and length of post-operative stay.
  
  
  RESULTS
  Between 2009 and 2013, 150 patients undergoing SRA were identified for inclusion: 51 in the auto, 49 in the control, and 50 in the TXA group. There were no differences in the pre-operative Hgb concentrations between groups. The mean post-operative Hgb was 11.3 g/dL (9.1 to 13.6) in the auto and TXA groups, and 10.6 g/dL (8.1 to 12.1)in the control group (p = 0.001). Accounting for cost of transfusions, administration of TXA, and length of stay, the cost per patient was $1731, $339, and $185 for the auto, control and TXA groups, respectively.
  
  
  CONCLUSIONS
  TXA use demonstrated higher post-operative Hgb concentrations when compared with controls and decreased peri-operative costs.
  
  
  CONCLUSIONS
  Tranexamic acid safely limits allogeneic transfusion, maintains post-operative haemoglobin, and decreases direct and indirect transfusion related costs in surface replacement arthroplasty.
authors: University of Washington, Meridian Ave N, Ste 270. Seattle, WA 98133, USA.
authors: A
authors: A
authors: Sassoon
authors: Washington University. School of Medicine, 660 S. Euclid Ave, Campus Box 8233, St Louis, MO 63110, USA.
authors: D
authors: D
authors: Nam
authors: Washington University. School of Medicine, 660 S. Euclid Ave, Campus Box 8233, St Louis, MO 63110, USA.
authors: R
authors: R
authors: Jackups
authors: Washington University. School of Medicine, 660 S. Euclid Ave, Campus Box 8233, St Louis, MO 63110, USA.
authors: S R
authors: SR
authors: Johnson
authors: Washington University. School of Medicine, 660 S. Euclid Ave, Campus Box 8233, St Louis, MO 63110, USA.
authors: R M
authors: RM
authors: Nunley
authors: Washington University. School of Medicine, 660 S. Euclid Ave, Campus Box 8233, St Louis, MO 63110, USA.
authors: R L
authors: RL
authors: Barrack
mesh_terms: D000933:Antifibrinolytic Agents / Q000191:economics / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000187:drug effects; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000191:economics / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid
keywords: tranexamic acid; total joint arthroplasty; blood transfusion