Cost Benefit Analysis of Topical Tranexamic Acid in Primary Total Hip and Knee Arthroplasty

Tuttle, John R.; Ritterman, Scott A.; Cassidy, Dale B.; Anazonwu, Walter A.; Froehlich, John A.; Rubin, Lee E.

doi:10.1016/j.arth.2014.01.031

Cited by 119 publications

(87 citation statements)

References 21 publications

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“…The transfusion rate in the present study was 3.3 %. Minimizing transfusions is another key factor that could decrease the economic burden of THA, as Tuttle et al estimated the cost of each transfusion to be $787.37 at their institution [13]. In addition to directly adding cost, transfusions have also been linked to increased incidence of complications, including deep surgical site infections [5].…”

Section: Other Outcomes Of Interestmentioning

confidence: 99%

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Gofton

Chow

Olsen

et al. 2014

International Orthopaedics (SICOT)

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Purpose Recent studies have reported nearly 40 % of costs associated with a 30-day episode-of-care for total joint replacements are due to post-discharge activities and 81 % of those are specifically due to unplanned readmissions and discharging patients to post-acute care facilities. The purpose of this study was to determine these two key variables for total hip arthroplasty (THA) patients implanted using a tissuesparing surgical technique and to see how these values compare to those previously reported in the United States. Methods The healthcare databases at three institutions were searched for primary THA patients implanted using the supercapsular percutaneously-assisted total hip (SuperPath) surgical technique between January 2013 and July 2014. Data elements included 30-day all-cause readmission rate, discharge status, transfusion rate, complications, and length of stay (LOS). Results Data were available for 479 THAs. The 30-day allcause readmission rate, transfusion rate, and average LOS was 2.3, 3.3 %, and 1.6 days, respectively. Over 91 % of patients were discharged routinely home, 4.1 % to skilled nursing facilities, 3.8 % to home health care, and 0.6 % to inpatient rehabilitation facilities. Complications included dislocation (0.8 %), periprosthetic fracture (0.8 %), and deep vein thrombosis (0.2 %). There were no infections reported. Conclusions Patients implanted using this tissue-sparing technique experienced reduced 30-day all-cause readmission rates (2.3 % vs. 4.2 %) and more were routinely discharged home (91.5 % vs. 27.3 %) than have been previously reported for patients in the United States. Use of this tissue-sparing technique has the potential to significantly reduce post-discharge costs.

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Section: Other Outcomes Of Interestmentioning

confidence: 99%

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Gofton

Chow

Olsen

et al. 2014

International Orthopaedics (SICOT)

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“…There is a cost-effective benefit as the use of TXA has been reported to reduce costs in hip and knee arthroplasty in addition to decreasing blood loss. 14 Oral TXA has been shown to decrease blood loss 2 and has similar efficiency as IV administration. 15 As the oral form of TXA is cheaper than the IV form, the financial benefit of oral TXA application has been reported as £2.04 (GB sterling) per patient.…”

Section: Introductionmentioning

confidence: 99%

The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

Çankaya

Daşar

Satilmis

et al. 2017

J Orthop Surg (Hong Kong)

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Aims: The combined (IV (intravenous) þ topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral þ topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA and whether oral þ topical use is as safe and efficient as the IV þ topical use, in addition to the main advantage of relatively low cost. Methods: In this prospective, randomized study, 100 patients were randomly assigned to either the topical TXA group or the combined (oral þ topical) TXA group. There were no significant differences between the groups in age, body mass index or gender. The haemoglobin and haematocrit levels of each patient were recorded preoperatively and on post-operative days 0, 1, 2 and 3. The post-operative suction drainage and blood transfusion volumes were also recorded. Results: There were statistically significant differences between the groups in haemoglobin and haematocrit levels on post-operative days 0, 1, 2 and 3 (p < 0.05) in favour of the combined group. The post-operative drainage amounts (p ¼ 0.0001), measured blood loss volume (p ¼ 0.003) and transfusion rates (p ¼ 0.03) were lower in the combined (oral þ topical) group compared to the topical group. Conclusions: Of the different methods of TXA administration, the combined use of oral and topical TXA is a safe, efficient and low-cost method in reducing blood loss and transfusion rates after TKA.

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“…Topical TXA in primary total knee and hip arthroplasty results in a saving of $83.73 per patient based on transfusion costs alone. 13 The financial benefit is £2.04 for a 70 kg patient with oral TXA use. 12 The total hospitalisation savings have been reported to be $1500 per patient after topical TXA use, 10 and $879 after TXA use.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Financial Benefits of Intra-Articular Tranexamic Acid in Total Knee Arthroplasty

Goyal

Chen

Harris

et al. 2016

J Orthop Surg (Hong Kong)

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Purpose. To determine whether intra-articular tranexamic acid (TXA) use after total knee arthroplasty (TKA) results in decreased postoperative blood transfusion and length of hospital stay. Methods. Medical records of 1981 patients (mean age, 69.2 years) who underwent primary TKA with (n=1006) or without (n=975) TXA use by any of 4 knee arthroplasty surgeons were reviewed. TXA (3000 mg/30ml) was administered via an epidural catheter into the knee joint after wound closure. Postoperative blood transfusion was given to patients with haemoglobin (Hb) level <80 g/dl on days 1 and 2 or with symptoms of acute anaemia. 2016;24(1):3-6 respect to the reduction in blood transfusion was AU$143.68 per patient. When the change in length of hospital stay and TXA costs were included, the overall saving was AU$631.36 per patient. Conclusion. Intra-articular TXA use can reduce costs as a result of decreased blood transfusion rate and length of hospital stay in patients undergoing TKA.

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Cost Benefit Analysis of Topical Tranexamic Acid in Primary Total Hip and Knee Arthroplasty

Cited by 119 publications

References 21 publications

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

Clinical and Financial Benefits of Intra-Articular Tranexamic Acid in Total Knee Arthroplasty

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