Effect and safety of topical application of tranexamic acid to reduce perioperative blood loss in elderly patients with intertrochanteric fracture undergoing PFNA

Abstract

Background: The specific method and dose of tranexamic acid (TXA) topically applied in intertrochanteric fracture have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically treated by our protocol in perioperative bleeding management for elderly patients with intertrochanteric fracture treated undergoing proximal femoral nail anti-rotation (PFNA). Methods: A retrospective comparative analysis was performed. Group TXA was comprised of 82 patients with topical use of TXA and group control was comprised of 82 patients without TXA during the procedure of PFNA. Intraoperative, total and hidden blood loss, drainage volume, postoperative blood transfusion volume and complications were compared between the two groups. Results: Intraoperative, total and hidden blood loss, and drainage volume were significantly lower in the TXA group than those in the control group (P=0.012, P<0.01, P<0.01, P=0.014, respectively). The volume and rate of blood transfusion in TXA group were significantly lower than those in the control group (P<0.01). There were no significant differences in complications between two groups (P>0.05). Conclusion: Topical application of TXA offers an effective and safe option in reducing perioperative blood loss and transfusion for elderly patients with intertrochanteric fractures undergoing PFNA.