Effectiveness and safety of tranexamic acid for perioperative bleeding after PFNA in elderly patients with unstable femoral intertorchanteric fracture
ZHANG Zhong-yan
LI Yu-bo
CHANG Tao
JIN Yu
Abstract：Objective To evaluate the efficacy and safety of intravenous drip of tranexamic acid ( TXA) for bleeding control after PFNA in elderly patients with unstable femoral intertorchanteric fracture. Methods A total of60 patients, from March 2014 to March 2017, were included. All were divided into 2 groups: Group A ( intravenous drip with 20 mg/kg TXA 30 minutes before surgery), Group B ( no TXA). Hemoglobin ( Hb) and hematocrit ( Hct) were recorded before operation and 1, 3, 5, 7 d, postoperatively. The total perioperative blood loss, dominant blood loss, hidden blood loss, transfusion rate, and complications of vascular events were compared between the 2 groups.Results The total amounts of perioperative blood loss and hidden blood loss were ( 760.7 ± 115.5) ml, ( 590.5 ±42.5) ml in Group A and ( 950.8 ± 110.9) ml, ( 780.5 ± 41.6) ml in Group B, with significant difference between the2 groups ( P = 0.00). Dominant blood loss: ( 152.5 ± 43.5) ml in Group A and ( 160.5 ± 41.1) ml in Group B, with no significant differences between the 2 groups ( P = 0.23). Blood transfusion rate: 4/30 in Group A and 15/30 in Group B, with significant differences between the 2 groups ( P = 0.00). There were 2 cases of lower extremity intermuscular venous thrombosis in Group A, and 3 cases of intramuscular venous thrombosis in Group B. No complications such as DVT, PE, acute coronary syndrome or acute cerebral infarction occurred and no statistically significant differences were observed ( P = 0.00). Conclusions Intravenous administration of tranexamic acid can significantly reduce perioperative blood loss and transfusion rate in unstable intertrochanteric fractures in elderly patients after PFNA. It does not increase the incidence of postoperative complications such as DVT, PE, etc., mainly with hidden blood loss.
Keywords：Tranexamic acidFracture fixationIntramedullaryFemoral fracturesHip fracturesPostoperative hemorrhage
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 225-228 )