title: Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip: results of a randomised controlled trial.
abstract: OBJECTIVE
  We chose unstable extra-capsular hip fractures as our study group because these types of fractures suffer the largest blood loss. We hypothesised that tranexamic acid (TXA) would reduce total blood loss (TBL) in extra-capsular fractures of the hip.
  
  
  METHODS
  A single-centre placebo-controlled double-blinded randomised clinical trial was performed to test the hypothesis on patients undergoing surgery for extra-capsular hip fractures. For reasons outside the control of the investigators, the trial was stopped before reaching the 120 included patients as planned in the protocol.
  
  
  RESULTS
  In all 72 patients (51 women, 21 men; 33 patients in the TXA group, 39 in the placebo group) were included in the final analysis, with a significant mean reduction of 570.8 ml (p = 0.029) in TBL from 2100.4 ml (standard deviation (sd) = 1152.6) in the placebo group to 1529.6 ml (sd = 1012.7) in the TXA group. The 90-day mortality was 27.2% (n = 9) in the TXA group and 10.2% (n = 4) in the placebo group (p = 0.07). We were not able to ascertain a reliable cause of death in these patients.
  
  
  CONCLUSIONS
  TXA significantly reduced TBL in extra-capsular hip fractures, but concerns regarding its safety in this patient group must be investigated further before the use of TXA can be recommended.
  
  
  CONCLUSIONS
  We present a randomised clinical trial that is unique in the literature. We evaluate the effect of TXA in very homogenous population - extra-capsular fractures operated with short intramedullary nails. Cite this article: Bone Joint J 2016;98-B:747-53.
authors.affiliation: Copenhagen University Hospital , Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.
authors.forename: P T
authors.initials: PT
authors.lastname: Tengberg
authors.affiliation: Copenhagen University Hospital , Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.
authors.forename: N B
authors.initials: NB
authors.lastname: Foss
authors.affiliation: Copenhagen University Hospital , Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Palm
authors.affiliation: Copenhagen University Hospital , Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Kallemose
authors.affiliation: Copenhagen University Hospital , Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Troelsen
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003718:Denmark; D004311:Double-Blind Method; D057239:Early Termination of Clinical Trials; D005260:Female; D005594:Fracture Fixation, Intramedullary; D006454:Hemoglobins / Q000032:analysis; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D014148:Tranexamic Acid / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid
keywords: Blood loss; Hip-fracture; Tranexamic acid