Preoperative Versus Intraoperative Intravenous Tranexamic Acid Efficacy in Reducing Blood Loss in Hip Fracture Surgeries: A Randomized Controlled Trial.

Abstract

Background: Hip fracture is common, with the reported lifetime prevalence of 20% for women and 10% for men. Despite recent advances in the techniques and instrumentation of orthopedic procedures, however, hip fracture surgery is still commonly associated with substantial blood loss, subsequent acute anaemia, and the need for transfusion. Postoperative anaemia in patients with hip fracture may lead to decreased ambulation, reduced functional independence and reduced walking distance on discharge Objective: To evaluate the efficacy of preoperative vs. intraoperative IV-TXA on postoperative blood loss following hip fracture surgery. Patients and Methods: A prospective randomized controlled study that was held on thirty adult patients with hip fracture who had a surgery. Results: The drains were removed in day 2. Mean volume of blood in the drain at day 0 was 140.00 ± 60.36 ml in group A as compared to 163.33 ± 66.73 ml in group B. Mean volume of blood in the drain at day 2 was 142.00 ± 85.54 ml in group A as compared 123.33 ± 56.27 ml in group B. Conclusion: The present study demonstrated that there is no significant difference between preoperative versus intraoperative IV-TXA in reducing blood loss in patients undergoing surgeries for hip and proximal femoral fractures. Additionally TXA administration in both groups caused a reduction in postoperative anemia and need for transfusion without significantly increasing the risk of thromboembolic events including DVT. This would in turn, help to avoid complications related with transfusion of blood and blood products.