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BMC Musculoskeletal Disorders

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Open Access 01-12-2019 | Tranexamic Acid | Research article

Topical tranexamic acid in elderly patients with femoral neck fractures treated with hemiarthroplasty: efficacy and safety? - a case-control study

Authors: Dae-Kyung Kwak, Chul-Young Jang, Dae-Hwan Kim, Sang-Hyun Rhyu, Ji-Hyo Hwang, Je-Hyun Yoo

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Abstract

Background

Perioperative blood management is an important issue in the treatment of elderly patients at an increased risk of postoperative complications. Accordingly, tranexamic acid (TXA) is widely administered to reduce blood loss and transfusion requirements. In this case-control study, the effect of topical TXA on the outcomes of elderly patients with femoral neck fractures after hemiarthroplasty was evaluated.

Methods

This study enrolled elderly patients (age ≥ 70 years) who underwent cementless bipolar hemiarthroplasty for femoral neck fractures between January 2015 and January 2017. The study group comprised 72 patients who received TXA via topical administration during surgery. After propensity matching, the control group comprised 72 patients who did not receive topical TXA. The perioperative and postoperative parameters of the two groups were compared.

Results

The estimated blood loss, vacuum tube drainage, and total transfusion volume were significantly lower in the study group than the control (p = 0.024, 0.003, and 0.019, respectively). Despite a lack of significant intergroup differences in the lengths of ICU and hospital stays; rates of ICU admission, venous thromboembolism, delirium, and readmission; and rates of in-hospital and 1-year mortality, the incidence of postoperative medical complications was significantly lower in the study group (p = 0.003).

Conclusion

Topical TXA administration appears to be a simple and effective option for reducing blood loss, transfusion requirements, and medical complications after hemiarthroplasty in elderly patients with femoral neck fractures.

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Title: Topical tranexamic acid in elderly patients with femoral neck fractures treated with hemiarthroplasty: efficacy and safety? - a case-control study
Authors: Dae-Kyung Kwak
Chul-Young Jang
Dae-Hwan Kim
Sang-Hyun Rhyu
Ji-Hyo Hwang
Je-Hyun Yoo
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Tranexamic Acid
Published in: BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-019-2615-z

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Topical tranexamic acid in elderly patients with femoral neck fractures treated with hemiarthroplasty: efficacy and safety? - a case-control study

Abstract

Background

Methods

Results

Conclusion

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Abstract

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