Τίτλος:
Efficacy and safety of tranexamic acid in hip fracture surgery. How does
dosage affect outcomes: A meta-analysis of randomized controlled trials
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim: The objective of this study was to assess the efficacy and safety
of intravenous TXA administration in elderly patients undergoing hip
fracture surgery focusing on the effect of various dosages. Methods: A
systematic search of PubMed, Embase and Cochrane Library was conducted
until February 2021. Our primary outcome was peri-operative total blood
loss, while secondary outcomes included transfusion rate, mean count of
transfused RBC units and thromboembolic events’ incidence. A subgroup
analysis was performed with respect to TXA dosage. Results: Out of 146
records identified, 10 randomized controlled studies met the selection
criteria. Data synthesis revealed that TXA resulted in a significant
reduction in total blood loss by 229.45 ml in favor of TXA; 95% CI:
[189.5, 269.4] and transfusion rate by 40%, RR = 0.60; 95% CI:
[0.47, 0.78]. No increase in thromboembolic events rate was observed
(RR = 1.08, 95% CI: [0.68, 1.69]) Furthermore, sub-analysis with
respect to TXA dosage showed no significant difference in total blood
loss reduction between “single” and “multiple doses” studies
(223 vs 233.5 ml, p = 0.85.), while a trend for lower complications rate
was observed in patients receiving a single dose of <= 15 mg/kg.
Conclusions: This meta-analysis provides strong evidence that TXA is a
safe and effective agent to reduce perioperative blood loss in hip
fracture surgery. When compared with higher dosages, a single dose of 15
mg/kg is associated with a non-significant reduction in adverse events,
while achieving comparable outcomes. (c) 2021 Elsevier Ltd. All rights
reserved.
Συγγραφείς:
Masouros, Panagiotis
Antoniou, Georgia
Nikolaou, Vasileios S.
Περιοδικό:
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
Εκδότης:
Elsevier Sci Ltd, Exeter, United Kingdom
Λέξεις-κλειδιά:
Tranexamic acid; Hip fracture; Transfusion rates; Total blood loss;
Meta-analysis
DOI:
10.1016/j.injury.2021.09.063
