Effect of Tranexamic Acid on Transfusion Rates Following Total Joint Arthroplasty: A Cost and Comparative Effectiveness Analysis.
Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively. Implementation of a TJA TXA protocol significantly reduced transfusions in a safe and cost-effective manner.
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York. Electronic address: perry.evangelista@nyumc.org.
Perry J
PJ
Evangelista
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York.
Michael W
MW
Aversano
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York; Department of Orthopaedic Surgery & Rehabilitation Administrative Office, Howard University Hospital Tower Building Suite 1700 Washington, DC 20064.
Emmanuel
E
Koli
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York.
Lorraine
L
Hutzler
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York.
Ifeoma
I
Inneh
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York.
Joseph
J
Bosco
Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Centre, New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, New York.
Richard
R
Iorio
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000379:methods / Q000706:statistics & numerical data; D057186:Comparative Effectiveness Research; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use*; D014481:United States
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
Blood transfusion; Cost comparative analysis; Primary joint arthroplasty; Tranexamic acid