Research Article
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Year 2022, Volume: 8 Issue: 5, 560 - 566, 04.09.2022
https://doi.org/10.18621/eurj.989590

Abstract

References

  • 1. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop 2011;45:15-22.
  • 2. Klestil T, Röder C, Stotter C, Winker B, Nehree S, Lutz M, et al. Immediate versus delayed surgery for hip fractures in the elderly patients: a protocol for a systematic review and meta-analysis. Syst Rev 2017;6:164.
  • 3. Kesmezacar H, Ayhan E, Unlu MC, Seker A, Karaca S. Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture. J Trauma 2010;68:153-8.
  • 4. Poh KS, Lingaraj K. Complications and their risk factors following hip fracture surgery. J Orthop Surg (Hong Kong) 2013;21:154-7.
  • 5. Xu S, Chen JY, Zhang Q, Lo NN, C SL, Tay KJD, et al. The safest and most efficacious route of tranexamic acid administration in total joint arthroplasty: a systematic review and network meta-analysis. Thromb Res 2019;176:61-6.
  • 6. Shichman I, Shaked O, Ashkenazi I, Schwarzkopf R, Warschawski Y, Snir N. Tranexamic acid in non-elective primary total hip arthroplasty. Injury 2021;52:1544-8.
  • 7. Narkbunnam R, Chompoonutprapa A, Ruangsomboon P, Udomkiat P, Chareancholvanich K, Pornrattanamaneewong C. Blood loss and transfusion rate compared among different dosing regimens of tranexamic acid administration in patients undergoing hip hemiarthroplasty for femoral neck fracture: A randomized controlled trial. Injury 2021;52:2986-90.
  • 8. Nikolaou VS, Masouros P, Floros T, Chronopoulos E, Skertsou M, Babis GC. Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial. Bone Joint J 2021;103-B:442-8.
  • 9. Ashkenazi I, Schermann H, Gold A, Lin R, Pardo I, Steinberg E, et al. Tranexamic acid in hip hemiarthroplasty. Injury. 2020;51:2658-62.
  • 10. Gausden EB, Garner MR, Warner SJ, Levack A, Nellestein AM, Tedore T, et al. Tranexamic acid in hip fracture patients: a protocol for a randomised, placebo-controlled trial on the efficacy of tranexamic acid in reducing blood loss in hip fracture patients. BMJ Open 2016;6:e010676.
  • 11. Liu W, Hui H, Zhang Y, Lin W, Fan Y. Intra-articular tranexamic acid injection during the hip hemi-arthroplasty in elderly patients: a retrospective study. Geriatr Orthop Surg Rehabil 2018;9:2151459318803851.
  • 12. Lee C, Freeman R, Edmondson M, Rogers BA. The efficacy of tranexamic acid in hip hemiarthroplasty surgery: an observational cohort study. Injury 2015;46:1978-82.
  • 13. Kang JS, Moon KH, Kim BS, Yang SJ. Topical administration of tranexamic acid in hip arthroplasty. Int Orthop 2017;41:259-63.
  • 14. Kwak DK, Jang CY, Kim DH, Rhyu SH, Hwang JH, Yoo JH. Topical tranexamic acid in elderly patients with femoral neck fractures treated with hemiarthroplasty: efficacy and safety?-a case-control study. BMC Musculoskelet Disord 2019;20:228.
  • 15. Porter SB, Spaulding AC, Duncan CM, Wilke BK, Pagnano MW, Abdel MP. Tranexamic acid was not associated with increased complications in high-risk patients with hip fracture undergoing arthroplasty. J Bone Joint Surg Am 2021;103:1880-9.
  • 16. Gross JB. Estimating allowable blood loss: corrected for dilution. Anesthesiology. 1983;58:277-80.
  • 17. Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery 1962;51:224-32.
  • 18. Liodakis E, Antoniou J, Zukor DJ, Huk OL, Epure LM, Bergeron SG. Major complications and transfusion rates after hemiarthroplasty and total hip arthroplasty for femoral neck fractures. J Arthroplasty 2016;31:2008-12.
  • 19. Song JH, Park JW, Lee YK, Kim IS, Nho JH, Lee KJ, et al. Management of blood Loss in hip arthroplasty: Korean Hip Society Current Consensus. Hip Pelvis 2017;29:81-90.
  • 20. Tengberg PT, Foss NB, Palm H, Kallemose T, Troelsen A. Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip: results of a randomised controlled trial [published correction appears in Bone Joint J 2016;98-B:1711-2]. Bone Joint J 2016;98-B:747-53.
  • 21. Engoren M, Mitchell E, Perring P, Sferra J. The effect of erythrocyte blood transfusions on survival after surgery for hip fracture. J Trauma 2008;65:1411-5.
  • 22. Gregersen M, Borris LC, Damsgaard EM. Blood transfusion and overall quality of life after hip fracture in frail elderly patients the transfusion requirements in frail elderly randomised controlled trial. J Am Med Dir Assoc 2015;16:762-6.
  • 23. Emara WM, Moez KK, Elkhouly AH. Topical versus intravenous tranexamic acid as a blood conservation intervention for reduction of postoperative bleeding in hemiarthroplasty. Anesth Essays Res 2014;8:48-53.
  • 24. Zufferey PJ, Miquet M, Quenet S, Martin P, Adam P, Albaladejo P, et al. Tranexamic acid in hip fracture surgery: a randomised controlled trial. Br J Anaesth. 2010;104:23-30.
  • 25. Watts CD, Houdek MT, Sems SA, Cross WW, Pagnano MW. Tranexamic acid safely reduced blood loss in hemi- and total hip arthroplasty for acute femoral neck fracture: a randomised clinical trial. J Orthop Trauma 2017;31:345-51.
  • 26. Cap AP, Baer DG, Orman JA, Aden J, Ryan K, Blackbourne LH. Tranexamic acid for trauma patients: a critical review of the literature. J Trauma 2011;71(1 Suppl):S9-14.

Is there a difference between tranexamic acid application routes in hip hemiarthroplasty?

Year 2022, Volume: 8 Issue: 5, 560 - 566, 04.09.2022
https://doi.org/10.18621/eurj.989590

Abstract

Objectives: This study aimed to define the optimal efficacy route of tranexamic acid treatment given during hemiarthroplasty after femoral neck fracture.

Methods: This study examined the files of patients with hip fractures over 65 years of age and treated surgically in our clinic between 2017 and 2019. Patients included in these files were grouped as non-tranexamic acid and topical and systemic tranexamic acid. Then, the demographic information, height and weight of the patient files, haemoglobin and hematocrit levels before and after the surgery, bleeding profiles, tranexamic acid dose and the route of administration, complications in postoperative follow-up, the amount of fluid coming from the drain and duration of drainage, postoperative intensive care follow-up duration of hospitalisation was investigated.


Results:
A total of 100 patients, 50 of whom were in the control group, 25 of whom were treated with topical tranexamic acid, and 25 of whom were treated with intravenous tranexamic acid, were included in this study. Postoperative blood transfusion was applied to 60% (n = 30) of the control group, 20% (n = 5) of the topical group, and 24% (n = 6) of the intravenous group. When compared statistically, it was found that topical and intravenous groups were lower than the control group (p = 0.001 and p = 0.002, respectively), but there was no significant difference between them (p = 0.759). When the blood loss calculations made by the Gross method were examined, the average of the control group was 1011.5 ml (179-1837 ml), the topical group was 695.7 ml (11-2503 ml), and the intravenous group was 710.9 ml (173-11315 ml) calculated as. When analysed statistically in terms of blood loss, it was found that the control group was significantly higher than the topical and intravenous groups, but there was no significant difference between the topical and intravenous groups (p = 0.002).


Conclusions:
Tranexamic acid applied to reduce blood loss during arthroplasty surgery can be used effectively either by topical or systemic methods.

References

  • 1. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop 2011;45:15-22.
  • 2. Klestil T, Röder C, Stotter C, Winker B, Nehree S, Lutz M, et al. Immediate versus delayed surgery for hip fractures in the elderly patients: a protocol for a systematic review and meta-analysis. Syst Rev 2017;6:164.
  • 3. Kesmezacar H, Ayhan E, Unlu MC, Seker A, Karaca S. Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture. J Trauma 2010;68:153-8.
  • 4. Poh KS, Lingaraj K. Complications and their risk factors following hip fracture surgery. J Orthop Surg (Hong Kong) 2013;21:154-7.
  • 5. Xu S, Chen JY, Zhang Q, Lo NN, C SL, Tay KJD, et al. The safest and most efficacious route of tranexamic acid administration in total joint arthroplasty: a systematic review and network meta-analysis. Thromb Res 2019;176:61-6.
  • 6. Shichman I, Shaked O, Ashkenazi I, Schwarzkopf R, Warschawski Y, Snir N. Tranexamic acid in non-elective primary total hip arthroplasty. Injury 2021;52:1544-8.
  • 7. Narkbunnam R, Chompoonutprapa A, Ruangsomboon P, Udomkiat P, Chareancholvanich K, Pornrattanamaneewong C. Blood loss and transfusion rate compared among different dosing regimens of tranexamic acid administration in patients undergoing hip hemiarthroplasty for femoral neck fracture: A randomized controlled trial. Injury 2021;52:2986-90.
  • 8. Nikolaou VS, Masouros P, Floros T, Chronopoulos E, Skertsou M, Babis GC. Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial. Bone Joint J 2021;103-B:442-8.
  • 9. Ashkenazi I, Schermann H, Gold A, Lin R, Pardo I, Steinberg E, et al. Tranexamic acid in hip hemiarthroplasty. Injury. 2020;51:2658-62.
  • 10. Gausden EB, Garner MR, Warner SJ, Levack A, Nellestein AM, Tedore T, et al. Tranexamic acid in hip fracture patients: a protocol for a randomised, placebo-controlled trial on the efficacy of tranexamic acid in reducing blood loss in hip fracture patients. BMJ Open 2016;6:e010676.
  • 11. Liu W, Hui H, Zhang Y, Lin W, Fan Y. Intra-articular tranexamic acid injection during the hip hemi-arthroplasty in elderly patients: a retrospective study. Geriatr Orthop Surg Rehabil 2018;9:2151459318803851.
  • 12. Lee C, Freeman R, Edmondson M, Rogers BA. The efficacy of tranexamic acid in hip hemiarthroplasty surgery: an observational cohort study. Injury 2015;46:1978-82.
  • 13. Kang JS, Moon KH, Kim BS, Yang SJ. Topical administration of tranexamic acid in hip arthroplasty. Int Orthop 2017;41:259-63.
  • 14. Kwak DK, Jang CY, Kim DH, Rhyu SH, Hwang JH, Yoo JH. Topical tranexamic acid in elderly patients with femoral neck fractures treated with hemiarthroplasty: efficacy and safety?-a case-control study. BMC Musculoskelet Disord 2019;20:228.
  • 15. Porter SB, Spaulding AC, Duncan CM, Wilke BK, Pagnano MW, Abdel MP. Tranexamic acid was not associated with increased complications in high-risk patients with hip fracture undergoing arthroplasty. J Bone Joint Surg Am 2021;103:1880-9.
  • 16. Gross JB. Estimating allowable blood loss: corrected for dilution. Anesthesiology. 1983;58:277-80.
  • 17. Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery 1962;51:224-32.
  • 18. Liodakis E, Antoniou J, Zukor DJ, Huk OL, Epure LM, Bergeron SG. Major complications and transfusion rates after hemiarthroplasty and total hip arthroplasty for femoral neck fractures. J Arthroplasty 2016;31:2008-12.
  • 19. Song JH, Park JW, Lee YK, Kim IS, Nho JH, Lee KJ, et al. Management of blood Loss in hip arthroplasty: Korean Hip Society Current Consensus. Hip Pelvis 2017;29:81-90.
  • 20. Tengberg PT, Foss NB, Palm H, Kallemose T, Troelsen A. Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip: results of a randomised controlled trial [published correction appears in Bone Joint J 2016;98-B:1711-2]. Bone Joint J 2016;98-B:747-53.
  • 21. Engoren M, Mitchell E, Perring P, Sferra J. The effect of erythrocyte blood transfusions on survival after surgery for hip fracture. J Trauma 2008;65:1411-5.
  • 22. Gregersen M, Borris LC, Damsgaard EM. Blood transfusion and overall quality of life after hip fracture in frail elderly patients the transfusion requirements in frail elderly randomised controlled trial. J Am Med Dir Assoc 2015;16:762-6.
  • 23. Emara WM, Moez KK, Elkhouly AH. Topical versus intravenous tranexamic acid as a blood conservation intervention for reduction of postoperative bleeding in hemiarthroplasty. Anesth Essays Res 2014;8:48-53.
  • 24. Zufferey PJ, Miquet M, Quenet S, Martin P, Adam P, Albaladejo P, et al. Tranexamic acid in hip fracture surgery: a randomised controlled trial. Br J Anaesth. 2010;104:23-30.
  • 25. Watts CD, Houdek MT, Sems SA, Cross WW, Pagnano MW. Tranexamic acid safely reduced blood loss in hemi- and total hip arthroplasty for acute femoral neck fracture: a randomised clinical trial. J Orthop Trauma 2017;31:345-51.
  • 26. Cap AP, Baer DG, Orman JA, Aden J, Ryan K, Blackbourne LH. Tranexamic acid for trauma patients: a critical review of the literature. J Trauma 2011;71(1 Suppl):S9-14.
There are 26 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Original Articles
Authors

Mustafa Yerli 0000-0002-2708-5812

Yunus İmren 0000-0002-8056-6156

Haluk Çabuk 0000-0002-1413-2149

Süleyman Semih Dedeoğlu 0000-0002-7441-5028

Ali Yüce 0000-0003-3751-6644

Tahsin Olgun Bayraktar 0000-0001-6544-1710

Nazım Erkurt This is me 0000-0003-4329-1437

Hakan Gürbüz 0000-0002-6437-5771

Publication Date September 4, 2022
Submission Date September 1, 2021
Acceptance Date February 23, 2022
Published in Issue Year 2022 Volume: 8 Issue: 5

Cite

AMA Yerli M, İmren Y, Çabuk H, Dedeoğlu SS, Yüce A, Bayraktar TO, Erkurt N, Gürbüz H. Is there a difference between tranexamic acid application routes in hip hemiarthroplasty?. Eur Res J. September 2022;8(5):560-566. doi:10.18621/eurj.989590

e-ISSN: 2149-3189 


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