The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture

Ivan B Stojadinovic; Branko M Ristic; Dragan R Knezevic; Zoran S Milenkovic; Nikola S Prodanovic; Nenad R Zornic; Jelena B Milosevic

doi:10.1515/med-2022-0482

The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture

Open Med (Wars). 2022 Apr 29;17(1):857-862. doi: 10.1515/med-2022-0482. eCollection 2022.

Authors

Ivan B Stojadinovic¹, Branko M Ristic^{2

3}, Dragan R Knezevic⁴, Zoran S Milenkovic², Nikola S Prodanovic^{5

3}, Nenad R Zornic⁶, Jelena B Milosevic⁷

Affiliations

¹ Department of Spinal Surgery, Clinic for Orthopedics and Traumatology, University Clinical Center Kragujevac, Kragujevac, 34000, Serbia.
² Department of Traumatology, Clinic for Orthopedics and Traumatology, University Clinical Center Kragujevac, Kragujevac, 34000, Serbia.
³ Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica St. 69, Kragujevac, 34000, Serbia.
⁴ Vascular Surgery Department, University Clinical Center Kragujevac, Kragujevac, 34000, Serbia.
⁵ Department of Alloartoplastic Surgery, Clinic for Orthopedics and Traumatology, University Clinical Center Kragujevac, Kragujevac, 34000, Serbia.
⁶ Department of Anesthesia and Intensive Care, University Clinical Center Kragujevac, Kragujevac, 34000, Serbia.
⁷ Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, 34000, Serbia.

Abstract

The aim of this study is to determine whether the use of tranexamic acid (TXA) in patients with hip fracture reduces intraoperative and postoperative blood loss, and on the other hand, whether it increases thromboembolic risk. The study was performed on patients with hip fracture for a period of one year. Patients were divided into two groups (1:1): the first group receiving TXA and the second group receiving placebo. The amount of blood aspiration during the surgery was measured as well as drainage in the postoperative period of 24 h. The occurrence of deep vein thrombosis (DVT) was monitored before and after the surgery by ultrasound of the lower extremities. The amount of total blood loss was two times lower in patients who received TXA (291.8 ± 65.5 mL of blood vs 634.7 ± 150.5 mL of blood). Among the patients who developed DVT, one patient was from the group that did not receive TXA, and two patients were from the group that received TXA. The use of TXA in patients with hip fracture significantly reduces intraoperative and postoperative blood loss, without a significant thromboembolic risk.

Keywords: blood loss; hip fracture; thromboembolism; tranexamic acid.