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International Orthopaedics

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01-02-2019 | Original Paper

The efficacy and safety of multiple-dose oral tranexamic acid on blood loss following total hip arthroplasty: a randomized controlled trial

Authors: Guorui Cao, Qiang Huang, Zeyu Huang, Shaoyun Zhang, Zeyu Luo, Yiting Lei, Zongke Zhou, Fuxing Pei

Published in: International Orthopaedics | Issue 2/2019

Abstract

Purposes

To explore the efficacy and safety of multiple-dose oral tranexamic acid (TXA) on blood loss following primary total hip arthroplasty (THA).

Methods

A total of 152 patients were randomized into three groups to receive 2 g of oral TXA two hours pre-operatively (group A), or another bolus of 2 g of oral TXA four hours post-operatively (group B), or another three boluses of 2 g of oral TXA four, ten, and 16 hours post-operatively (group C). The primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and transfusion rate. The secondary outcomes were haemoglobin (Hb) and haematocrit (Hct) drop, the level of fibrinolysis parameters (fibrin degradation products, D-dimer), and complications (thrombotic diseases, stroke, cardiac infarction, and infection).

Results

The mean TBL and HBL in group C were lower than those in group A (p < 0.001 and p < 0.001) and group B (p = 0.012 and p = 0.029). The Hb drop on post-operative day one (POD1) and POD3 in group C was lower than those in group A (p < 0.001 and p = 0.029) and group B (p < 0.001 and p = 0.004). The difference was similar regarding Hct drop on POD3 (p < 0.001 and p = 0.014). Moreover, fibrin degradation products and D-dimer in group C were lower than in groups A and B on POD1 and POD3 (p < 0.001 and p < 0.001). The incidence of complications such as venous thromboembolism did not differ significantly among the three groups (p > 0.05).

Conclusions

Multiple boluses of oral TXA could further reduce blood loss, Hb and Hct drop, and restrain post-operative fibrinolysis in primary THA without increasing the risk of complications.

Level of Evidence I

Therapeutic study.

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Title: The efficacy and safety of multiple-dose oral tranexamic acid on blood loss following total hip arthroplasty: a randomized controlled trial
Authors: Guorui Cao
Qiang Huang
Zeyu Huang
Shaoyun Zhang
Zeyu Luo
Yiting Lei
Zongke Zhou
Fuxing Pei
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 2/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3925-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The efficacy and safety of multiple-dose oral tranexamic acid on blood loss following total hip arthroplasty: a randomized controlled trial

Abstract

Purposes

Methods

Results

Conclusions

Level of Evidence I

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purposes

Methods

Results

Conclusions

Level of Evidence I

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