Impact of Tranexamic Acid in Total Knee and Total Hip Replacement.

Impact of Tranexamic Acid in Total Knee and Total Hip Replacement.

Boyle Jaclyn A; Soric Mate M

Journal of pharmacy practice

2017

2017-02

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 \textless .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 \textless .01). CONCLUSION: 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.

Aged; Antifibrinolytic Agents/adverse effects/therapeutic use; Arthroplasty; Blood Transfusion; Blood Transfusion/statistics & numerical data; Case-Control Studies; Descriptive Statistics; Female; Hemoglobins – Analysis; Hemoglobins/metabolism; Hip; Hip/*methods; Human; Humans; Knee; Knee/*methods; Length of Stay – Evaluation; Length of Stay/statistics & numerical data; Male; Outcome Assessment; Replacement; Retrospective Design; Retrospective Studies; total hip replacement; total knee replacement; tranexamic acid; Tranexamic Acid – Administration and Dosage; Tranexamic Acid/adverse effects/*therapeutic use; Venous Thromboembolism – Risk Factors; Venous Thromboembolism/epidemiology

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