Tranexamic acid reduces blood loss in hip arthroplasty for senile femoral neck fracture

Abstract

Objective To investigate the effect of intraoperative dripping of intravenous tranexamic acid (TXA) on the perioperative blood loss in elderly patients undergoing hip arthroplasty for femoral neck fracture. Methods From January 2016 to August 2017, 118 elderly patients with femoral neck fracture were treated with hip arthroplasty at Department of Orthopaedics, China-Japan Friendship Hospital. They were 45 males and 73 females, with an average age of 77.1 years. Of them, 60 (TXA group) were subjected to intravenous TXA dripping over 10 minutes by 2 doses (15 mg/kg TXA dissolved in 100 mL of saline) with the first dose before incision and the second one at wound closure; 58 (control group) were subjected to intravenous administration of 100 mL of saline solution in a similar fashion. Blood routine tests were carried out one day before operation, and the first and third days after operation. The transfusion rate and volume, and surgical blood loss were recorded. The total blood loss on postoperative 1-day and 3-day were calculated according to hemoglobin balance method. The 2 groups were compared in terms of blood loss and complications. Results The blood transfusion rate (21.7%), blood transfusion volume (310.8±85.7 mL), surgical blood loss (424.3±87.6 mL), total blood loss on postoperative 1-day (1,284.6±288.7 mL) and total blood loss on postoperative 3-day (1,501.2±337.1 mL) in the TXA group were all significantly lower than those in the control group (41.4%, 379.8±110.2 mL, 526.7±113.8 mL, 1,534.8±279.2 mL and 1,887.4±431.8 mL, respectively) (P 0.05). Conclusion In elderly patients undergoing hip arthroplasty for femoral neck fracture, intravenous TXA administration may lower transfusion rate, reduce transfusion volume, and decrease surgical blood loss and postoperative total blood loss without increasing the risks of surgery-related complications like thrombosis. Key words: Tranexamic acid; Femoral neck fractures; Arthroplasty, replacement, hip; Postoperative hemorrhage