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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 10/2022

28-10-2021 | Tranexamic Acid | Arthroscopy and Sports Medicine

Tranexamic acid usage in hip fracture surgery: a meta-analysis and meta-regression analysis of current practice

Authors: Wenhua Liu, Shaojie Deng, Jinfeng Liang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2022

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Abstract

Introduction

The use of tranexamic acid (TXA) in hip fracture surgery remains inconclusive. The aim of the present meta-analysis was to assess the role of TXA use in hip fracture surgery, and attempt to disclose possible factors which might influence TXA efficacy and safety.

Materials and methods

A systematic computerized literature search was conducted to retrieve all randomized controlled trials (RCTs) and cohort studies regarding TXA use in hip fracture surgery. Overall efficacy and safety were evaluated. Then, subgroup and meta-regression analyses were conducted to disclose the influence of geographic area, fracture type, administration route, frequency and dosage of TXA, blood transfusion threshold, and follow-up duration on the overall effect.

Results

Thirty-four RCTs and 11 cohort studies were included. Patients receiving TXA had a significant decrease in the need for blood transfusion, reduced total, intra-operative and post-operative blood loss, a decrease in pre- and postoperative hemoglobin difference, without increasing thromboembolic events risk. Subgroup analysis showed that topical TXA had a lower transfusion rate compared with controls, yet the result did not reach statistical significance. Also, TXA had similar efficacy and safety profiles in patients with different frequency and dosage of TXA.

Conclusion

Current evidence indicated that intravenous administration of TXA could significantly reduce blood transfusion and blood loss without increasing risk of thromboembolic events. The frequency and dosage of TXA might not alter the beneficial effect. The application of topical TXA should be cautious.
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Metadata
Title
Tranexamic acid usage in hip fracture surgery: a meta-analysis and meta-regression analysis of current practice
Authors
Wenhua Liu
Shaojie Deng
Jinfeng Liang
Publication date
28-10-2021
Publisher
Springer Berlin Heidelberg
Keyword
Tranexamic Acid
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 10/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-021-04231-1

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