- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT01714336
Does Tranexamic Acid Reduce the Need for Blood Transfusions in Patients Undergoing Hip Fracture Surgery?
12. november 2018 oppdatert av: Mark Pagnano, Mayo Clinic
Is Tranexamic Acid Effective in Limiting Transfusion After Hip Replacement for Femoral Neck Fracture: A Randomized Controlled Trial
Does tranexamic acid improve the perioperative care of those patients treated surgically for hip fracture by decreasing the proportion of patients requiring transfusion and decreasing total perioperative bleeding.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Antifibrinolytic medications such as tranexamic acid, aprotinin, and aminocaproic acid have proven to be useful in decreasing blood loss and the proportion of patients who require transfusion after a number of surgical procedures.
In orthopedic surgery, tranexamic acid (TXA) is the best studied of these medications and a recent Cochrane Database review determined that tranexamic acid was effective in decreasing perioperative bleeding and post-operative transfusion after elective hip replacement and knee replacement surgery.
At Mayo Clinic Rochester, the routine administration of tranexamic acid has evolved over the past decade to become part of the typical protocol for more than 3,000 elective hip and knee replacement procedures each year.
Recent administrative data provides fairly compelling evidence of the efficacy of tranexamic acid in decreasing transfusion at the Mayo Clinic Rochester practice with 2010 data showing 2% and 7% prevalence of transfusion in patients treated with tranexamic acid versus 18% and 33% prevalence in those knee and hip replacement patients, respectively, who were not treated with tranexamic acid.
A recent analysis of the Mayo Clinic Rochester orthopedic practice showed that patients treated for hip fracture remain at substantial risk of perioperative transfusion (30% prevalence) after operative management.
This raises the question as to whether tranexamic acid could improve the perioperative care of those patients treated surgically for hip fracture by decreasing the proportion of patients requiring transfusion and decreasing total perioperative bleeding.
Studietype
Intervensjonell
Registrering (Faktiske)
138
Fase
- Fase 4
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
Minnesota
-
Rochester, Minnesota, Forente stater, 55905
- Mayo Clinic in Rochester
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion criteria
- AO/OTA (Orthopedic Trauma Association) fracture classification 31B
- Surgically treated with either hemiarthroplasty or total hip arthroplasty
- Acute fracture treated within 72 hours of injury
- Low energy isolated injury
- Age greater than 18 years old
Exclusion Criteria
- Transfusion received during admission, prior to surgery
- Creatinine clearance less than 30 mL/min
- History of unprovoked Venous Thromboembolism (VTE) and/or recurrent VTE
- Known history of Factor V Leiden, protein C/S deficiency, prothrombin gene mutation, anti-thrombin deficiency, anti-phospholipid antibody syndrome, lupus anticoagulant
- Pregnancy or breastfeeding (pregnancy tests will be performed on all patients of child-bearing potential)
- History of cerebrovascular accident (CVA), Myocardial infarction (MI), or VTE within the previous 30 days
- Coronary stent placement within the previous 6 months
- Disseminated intravascular coagulation
- Subarachnoid hemorrhage
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Forebygging
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Placebo komparator: placebo
Normal saline will be administered intravenously in two doses of 15 mg/kg each administered over a period of ten minutes, one dose just prior to incision and the second at initiation of wound closure.
|
A similar dose of 0.9% sodium chloride (NaCL) will be administered intravenously in two doses over a ten minute period, one dose at incision and the other at initiation of wound closure.
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Aktiv komparator: tranexamic acid
Tranexamic acid will be administered intravenously in two doses of 15 mg/kg each administered over a period of ten minutes, one dose just prior to incision and the second at initiation of wound closure.
|
Tranexamic acid will be administered intravenously in two doses of 15 mg/kg.
Each dose will be administered over a period of ten minutes, one dose just prior to incision and the second at initiation of wound closure.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Number of Participants Who Received a Hospitalization Transfusion
Tidsramme: 5 days
|
Proportion of patients transfused at least 1 unit of packed red blood cells during hospital admission
|
5 days
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Mean Number of Units Transfused
Tidsramme: 5 days
|
Mean number of units transfused per patient
|
5 days
|
Calculated Blood Loss
Tidsramme: 5 days
|
Calculated blood loss
|
5 days
|
Number of Participants With Venous Thromboembolism (VTE) Diagnosis
Tidsramme: Within 6 months of surgery
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Incidence of symptomatic VTE diagnosed within 6 months of surgery
|
Within 6 months of surgery
|
Number of Participants With Wound Complications
Tidsramme: Within 6 months of surgery
|
Wound complications diagnosed within 6 months of surgery
|
Within 6 months of surgery
|
Number of Participants With Myocardial Infarction (MI) Diagnosis
Tidsramme: Within 6 months of surgery
|
MI diagnosed within 6 months of surgery
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Within 6 months of surgery
|
Number of Participants With Cerebrovascular Accident (CVA) Diagnosis
Tidsramme: Within 6 months of surgery
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CVA diagnosed within 6 months of surgery
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Within 6 months of surgery
|
Number of Participants Who Died
Tidsramme: 6 months after surgery
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All-cause mortality at 6 months
|
6 months after surgery
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Mark Pagnano, MD, Mayo Clinic
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. september 2012
Primær fullføring (Faktiske)
1. oktober 2015
Studiet fullført (Faktiske)
1. oktober 2015
Datoer for studieregistrering
Først innsendt
23. oktober 2012
Først innsendt som oppfylte QC-kriteriene
23. oktober 2012
Først lagt ut (Anslag)
25. oktober 2012
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
14. november 2018
Siste oppdatering sendt inn som oppfylte QC-kriteriene
12. november 2018
Sist bekreftet
1. november 2018
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 12-004599
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
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