Does Tranexamic Acid Reduce Blood Loss in Acetabular Fracture Surgery?

Atchison, Jared; Zaidi, Syed Shahid Nafees; Eno, Blessing; Schloss, Michael; Mulliken, Alexandra; Hannan, Zachary D.; Ding, Anthony; O’Hara, Nathan N.

doi:10.26226/morressier.5cffabaef6074e97f94aae62

Cited by 1 publication

(7 citation statements)

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“…[ 11 ] Four studies received a point deduction due to the lack of a prospective calculation of the study size. [ 12 – 15 ] There were no further point deductions in the other criteria domains.…”

Section: Resultsmentioning

confidence: 99%

“…Atchison et al (2019) [12] EBL, OR of transfusion rate Intraoperative EBL as reported in the anesthesia records Intraoperative N/A Criner et al (2016) [13] EBL, number of pRBC transfused, operation time, rate of blood loss, VTE…”

Section: Investigated Period For Transfusion Indication For Transfusionmentioning

confidence: 99%

“…Of the 6 included studies, 2 were RCTs, [10,11] and 4 were retrospective comparative studies. [12][13][14][15] In total, 764 patients were involved in the studies selected, including 293 patients who had received TXA (TXA group) and 471 patients who had not (control group). All the included studies involved acetabular fracture and/or pelvis fracture.…”

Section: Study Characteristics and Qualitative Synthesismentioning

confidence: 99%

“…All the included studies involved acetabular fracture and/or pelvis fracture. In 5 studies, intravenous (IV) TXA [10][11][12][13][14] administration had been undertaken, and 1 study involved a topical TXA application. [15] Demographic data and study characteristics, including the TXA regimen for each study, are shown in Table 1.…”

Section: Study Characteristics and Qualitative Synthesismentioning

confidence: 99%

“…Two studies used formula by Nadler et al to calculate EBL, [11,15] and 1 study used EBL as reported in anesthesia records. [12] Four studies evaluated the transfusion profile over the whole study period, [10,11,14,15] and we extracted intraoperative transfusion-related data from 3 studies [11][12][13] and postoperative transfusion-related data from 3 studies. [11,13,15] Three studies reported the indications for pRBC transfusion, the Hb level <7 or 8 g/dL, or symptomatic anemia.…”

Section: Study Characteristics and Qualitative Synthesismentioning

confidence: 99%

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The effect of tranexamic acid in open reduction and internal fixation of pelvic and acetabular fracture: A systematic review and meta-analysis

et al. 2022

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Background: Pelvic bone fractures may cause extensive bleeding; however, the efficacy of tranexamic acid (TXA) usage in pelvic fracture surgery remains unclear. In this systematic review and meta-analysis, we aimed to evaluate the efficacy of TXA in open reduction and internal fixation surgery for pelvic and acetabular fracture. Methods: MEDLINE, Embase, and Cochrane Library databases were systematically searched for studies published before April 22, 2020, that investigated the effect of TXA in the treatment of pelvic and acetabular fracture with open reduction and internal fixation. A pooled analysis was used to identify the differences between a TXA usage group and a control group in terms of estimated blood loss (EBL), transfusion rates, and postoperative complications. Results: We included 6 studies involving 764 patients, comprising 293 patients who received TXA (TXA group) and 471 patients who did not (control group). The pooled analysis showed no differences in EBL between the groups (mean difference –64.67, 95% confidence interval [CI] –185.27 to –55.93, P = .29). The study period transfusion rate showed no significant difference between the groups (odds ratio [OR] 0.77, 95% CI 0.19–3.14, P = .71, I2 = 82%), nor in venous thromboembolism incidence (OR 1.53, 95% CI 0.44–5.25, P = .50, I2 = 0%) or postoperative infection rates (OR 1.15, 95% CI 0.13–9.98, P = .90, I2 = 48%). Conclusions: Despite several studies having recommended TXA administration in orthopedic surgery, our study did not find TXA usage to be more effective than not using TXA in pelvic and acetabular fracture surgery, especially in terms of EBL reduction, transfusion rates, and the risk of postoperative complications.

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Section: Resultsmentioning

confidence: 99%

Section: Investigated Period For Transfusion Indication For Transfusionmentioning

confidence: 99%