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European Journal of Orthopaedic Surgery & Traumatology

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21-10-2023 | Tranexamic Acid | Original Article

Interaction of preoperative chemoprophylaxis and tranexamic acid use does not affect transfusion in acetabular fracture surgery

Authors: Harsh Wadhwa, Matthew Rohde, Yousi Oquendo, Michael J. Chen, Seth S. Tigchelaar, Michael Bellino, Julius Bishop, Michael J. Gardner

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2024

Abstract

Purpose

While the effects of tranexamic acid (TXA) use on transfusion rates after acetabular fracture surgery are unclear, previous evidence suggests that holding deep vein thrombosis (DVT) chemoprophylaxis may improve TXA efficacy. This study examines whether holding DVT chemoprophylaxis in patients receiving TXA affects intraoperative and postoperative transfusion rates in acetabular fracture surgery.

Methods

We reviewed electronic medical records (EMR) of 305 patients who underwent open reduction and internal fixation of acetabular fractures (AO/OTA 62) and stratified patients per the following perioperative treatment: (1) no intraoperative TXA (noTXA), (2) intraoperative TXA and no preoperative DVT prophylaxis (opTXA/noDVTP), or (3) intraoperative TXA and preoperative DVT prophylaxis (opTXA/opDVTP). The primary outcomes were need for intraoperative or postoperative transfusion. Risk factors for each primary outcome were assessed using multivariable regression.

Results

Intraoperative or postoperative transfusion rates did not significantly differ between opTXA/opDVTP and opTXA/noDVTP groups (46.2% vs. 36%, p = 0.463; 15.4% vs. 28%, p = 0.181). Median units transfused did not differ between groups (2 ± 1 vs. 2 ± 1, p = 0.515; 2 ± 1 vs. 2 ± 0, p = 0.099). There was no association between preoperative DVT chemoprophylaxis and TXA with intraoperative or postoperative transfusions. EBL, preoperative hematocrit, and IV fluids were associated with intraoperative transfusions; age and Charlson Comorbidity Index (CCI) were associated with postoperative transfusions.

Conclusion

Our findings suggest holding DVT prophylaxis did not alter the effect of TXA on blood loss or need for transfusion.

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Title: Interaction of preoperative chemoprophylaxis and tranexamic acid use does not affect transfusion in acetabular fracture surgery
Authors: Harsh Wadhwa
Matthew Rohde
Yousi Oquendo
Michael J. Chen
Seth S. Tigchelaar
Michael Bellino
Julius Bishop
Michael J. Gardner
Publication date: 21-10-2023
Publisher: Springer Paris
Keywords: Tranexamic Acid
Phlebothrombosis
Acetabular Fracture
Anticoagulant
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03763-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Interaction of preoperative chemoprophylaxis and tranexamic acid use does not affect transfusion in acetabular fracture surgery

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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