Tranexamic acid in non-elective primary total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Pharmacology

Background:

• Significant blood loss during total hip arthroplasty (THA) can necessitate allogeneic blood transfusions, posing risks.
• Intraoperative tranexamic acid (TXA) is effective in reducing transfusions in elective THA.
• Limited data exists on TXA's efficacy in non-elective primary THA, particularly in trauma patients.

Purpose of the Study:

• To evaluate the efficacy of perioperative tranexamic acid (TXA) in reducing blood loss.
• To assess the impact of TXA on allogeneic blood transfusion requirements in non-elective primary THA.
• To compare perioperative complications, readmissions, and mortality between TXA and no-TXA groups.

Main Methods:

• Retrospective analysis of a consecutive cohort undergoing non-elective primary THA (2011-2019).
• Patients divided into two groups: perioperative TXA treatment and no TXA treatment.
• Comparison of blood loss (hemoglobin change), blood product administration, complications, readmissions, and mortality.

Main Results:

• TXA use was associated with significantly reduced postoperative bleeding (ΔHb: -2.75 gr/dL vs. -3.34 gr/dL, p<0.001).
• Fewer patients in the TXA group received allogeneic blood transfusions (7.0% vs. 16.3%, p=0.004).
• A total of 419 patients were included; 315 received TXA and 104 did not.

Conclusions:

• Perioperative tranexamic acid (TXA) significantly reduces postoperative blood loss in non-elective primary THA.
• TXA use decreases the need for allogeneic blood transfusions in this patient population.
• Findings support the routine use of TXA in non-elective THA, similar to its established role in elective THA.