- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05518279
Early Administration Of Tranexamic Acid And Acute Blood Loss In Patients With Hip Fractures
August 24, 2022 updated by: Trent Guthrie, Henry Ford Health System
Early Administration Of Tranexamic Acid And Acute Blood Loss In Patients With Hip Fractures: A Prospective, Randomized, Double-blinded, Placebo Controlled Trial
The study is a prospective, randomized, double blinded, placebo controlled trial that aims to investigate the hypothesis that early administration of tranexamic acid (TXA) following diagnosis of hip fracture will lower pre and postoperative blood loss and transfusion rates.
Patients who present to the hospital with a hip fracture will be recruited and randomized into two treatment arms.
The treatment group will receive 1950mg of oral TXA (three tablets, 650 mg each) and the control group will be given three tablets of oral placebo while in the Emergency Department.
Patients will then be admitted to the Orthopaedic Trauma service and treated surgically with cephalomedullary nail, hemiarthroplasty, sliding hip screw, percutaneous screws, or total hip arthroplasty.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
There remains a high incidence of blood transfusion in patients following hip fractures.
Tranexamic acid (TXA) has well-studied efficacy in decreasing blood loss and transfusion requirements in the context of general trauma, as well as several elective orthopaedic procedures.
Although blood is lost in hip fracture surgery itself, it is also known that there is significant blood loss pre-operatively following the hip fracture event, particularly in extracapsular hip fractures.
A prospective, randomized, double blinded, placebo controlled trial will elucidate the roll of early administration of TXA in a population of patients who sustain hip fractures.
The study aims to investigate the hypothesis that early administration of TXA following diagnosis of hip fracture will lower pre and postoperative blood loss and transfusion rates.
There will be two treatment arms in the study.
The treatment group will be given 1950mg of oral TXA (3 tablets, 650mg each) in the emergency department following diagnosis of hip fracture.
Those randomized to the control group will be given 3 tablets of oral placebo in the emergency department following diagnosis of hip fracture.
Patients will then be admitted to the Orthopaedic Trauma service and treated surgically with cephalomedullary nail, hemiarthroplasty, sliding hip screw, percutaneous screws, or total hip arthroplasty.
Study Type
Interventional
Phase
- Phase 3
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
50 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age over 50
- Clinical diagnosis of acute femoral neck, intertrochanteric or subtrochanteric femur fracture
Exclusion Criteria:
- anticoagulant use at time of admission to emergency department
- documented allergy to tranexamic acid
- history of deep vein thrombosis or pulmonary embolism
- hepatic dysfunction (aspartate aminotransferase (AST)/alanine aminotransferase (ALT) > 60)
- renal dysfunction (Creatinine > 1.5 or Glomerular Filtration Rate < 30)
- active coronary artery disease (event within 12 months)
- history of cerebral vascular accident within 12 months
- presence of drug eluting stent
- color blindness
- active cancer
- coagulopathy (International Normalized Ratio > 1.4, Partial Thromboplastin Time > 1.4 times normal, platelets < 50,000)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Tranexamic Acid Treatment Group
The intervention for the treatment group is as follows: participants in this treatment arm will given 1950mg of oral tranexamic acid pills (3 tablets, 650mg each) in the emergency department following diagnosis of hip fracture.
|
Patients will receive 1950mg of an oral tranexamic acid pill (3 pills total) while down in the Emergency Department after being diagnosed with a hip fracture.
After they receive the oral TXA and are medically optimized, they will be taken to the operating room for fracture fixation.
|
Placebo Comparator: Oral Placebo Control Group
The intervention for the control group is as follows: participants in this treatment arm will given 3 tablets of oral placebo pills in the emergency department following diagnosis of hip fracture.
|
Patients in the control arm will receive 3 placebo pills while down in the Emergency Department after being diagnosed with a hip fracture.
After they receive the placebo pills and are medically optimized for surgery, they will be taken to the operating room for fracture fixation.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood transfusion rate
Time Frame: This outcome will be recorded daily from the time of admission to the Emergency Department through the time of discharge from the hospital, assessed up to 7 days.
|
Preoperative, intraoperative, and postoperative blood transfusions will be considered as the primary outcome measure.
This outcome will be measured in number of units of packed red blood cells administered during the participant's hospital stay.
|
This outcome will be recorded daily from the time of admission to the Emergency Department through the time of discharge from the hospital, assessed up to 7 days.
|
Hemoglobin Level
Time Frame: This outcome will be recorded daily from the time of admission to the Emergency Department to the time of discharge from the hospital, up to 7 days.
|
Labs, specifically a complete blood count (CBC) to evaluate a hemoglobin level (in grams per deciliter), will be drawn at the following time points: Admission to the Emergency Department, nightly (9pm) for each day of hospitalization and one hour after completion of a blood transfusion.
|
This outcome will be recorded daily from the time of admission to the Emergency Department to the time of discharge from the hospital, up to 7 days.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Estimated blood loss
Time Frame: Starting at time of surgical incision and will end once the surgery is completed.
|
Measured amount of blood loss recorded during the surgery.
These values will be compared between the two study arms to determine if administration of oral TXA decreases the intra-operative blood loss.
|
Starting at time of surgical incision and will end once the surgery is completed.
|
Frequency of adverse events.
Time Frame: From time of admission to the Emergency department up to 12 months after the date of surgery. Outcome measure will be recorded daily while participant is hospitalized and monthly after discharge from the hospital.
|
Documentation of any adverse events in the peri-operative period.
For example, transfusion reaction, myocardial infarction, symptomatic deep vein thrombosis, pulmonary embolism, stroke, reoperation, readmission, infection, and death.
|
From time of admission to the Emergency department up to 12 months after the date of surgery. Outcome measure will be recorded daily while participant is hospitalized and monthly after discharge from the hospital.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Trent Guthrie, MD, Henry Ford Hospital Department of Orthopaedic Surgery
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
September 1, 2019
Primary Completion (Anticipated)
August 1, 2021
Study Completion (Anticipated)
September 1, 2021
Study Registration Dates
First Submitted
January 22, 2019
First Submitted That Met QC Criteria
August 24, 2022
First Posted (Actual)
August 26, 2022
Study Record Updates
Last Update Posted (Actual)
August 26, 2022
Last Update Submitted That Met QC Criteria
August 24, 2022
Last Verified
August 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 11411
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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