Intravenous Versus Locally Injected Tranexamic Acid in a Fragility Hip Fracture Population: A Retrospective Review.

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Pharmacology

Background:

• Fragility hip fractures are common in elderly patients.
• Postoperative blood transfusions are frequently required.
• Tranexamic acid (TXA) is used to reduce blood loss.

Purpose of the Study:

• To compare the effectiveness of intravenous (IV) TXA versus locally injected (Local) TXA in reducing blood transfusions and complications.
• To evaluate complication rates and 30-day readmissions in fragility hip fracture patients receiving IV TXA, Local TXA, or no TXA.

Main Methods:

• Retrospective comparative cohort study.
• Included patients aged 50+ undergoing surgery for proximal femur fragility fractures.
• Compared outcomes (transfusion, VTE, SSI, readmissions) between IV TXA, Local TXA, and control groups.

Main Results:

• Both IV and Local TXA reduced transfusions compared to controls.
• IV TXA showed a 12% greater transfusion reduction than Local TXA (P < 0.001).
• IV TXA significantly lowered 30-day readmission rates (5%) compared to Local TXA (13.8%) and controls (13.9%).

Conclusions:

• IV TXA is superior to Local TXA in reducing postoperative blood transfusions in fragility hip fracture patients.
• IV TXA is safe, does not increase complications, and lowers 30-day readmissions.
• IV TXA is an effective strategy for managing blood loss in this patient population.