Effect of Tranexamic Acid on Transfusion Rates Following Total Joint Arthroplasty: A Cost and Comparative Effectiveness Analysis

Orthop Clin North Am. 2017 Apr;48(2):109-115. doi: 10.1016/j.ocl.2016.12.001. Epub 2017 Jan 30.

Abstract

Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively. Implementation of a TJA TXA protocol significantly reduced transfusions in a safe and cost-effective manner.

Keywords: Blood transfusion; Cost comparative analysis; Primary joint arthroplasty; Tranexamic acid.

MeSH terms

  • Antifibrinolytic Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / methods
  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion* / methods
  • Blood Transfusion* / statistics & numerical data
  • Comparative Effectiveness Research
  • Cost Savings
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tranexamic Acid / therapeutic use*
  • United States

Substances

  • Antifibrinolytic Agents
  • Tranexamic Acid