Tranexamic acid reduces hidden blood loss in the treatment of intertrochanteric fractures with PFNA: a single-center randomized controlled trial

Jinlai Lei, Binfei Zhang, Yuxuan Cong, Yan Zhuang, Xing Wei, Yahui Fu, Wei Wei, Pengfei Wang, Shiming Wen, Hai Huang, Hu Wang, Shuang Han, Shuguang Liu, Kun Zhang, Jinlai Lei, Binfei Zhang, Yuxuan Cong, Yan Zhuang, Xing Wei, Yahui Fu, Wei Wei, Pengfei Wang, Shiming Wen, Hai Huang, Hu Wang, Shuang Han, Shuguang Liu, Kun Zhang

Abstract

Background: Hidden blood loss is a major concern for patients undergoing hip surgery for intertrochanteric fracture. The objective of this study was to investigate whether tranexamic acid (TXA) could reduce postoperative hidden blood loss in patients undergoing hip surgery for intertrochanteric fracture.

Methods: A total of 77 patients with intertrochanteric fracture were enrolled in this randomized controlled study. Patients received either 200 mL (1 g) of TXA (n = 37) or normal-saline (NS) (n = 40) i.v. before hip surgery using proximal femoral nail anti-rotation (PFNA). Hemoglobin and hematocrit levels were measured preoperatively and postoperatively at day 1 and 3. Visible and hidden blood loss volumes were calculated at postoperative day 3.

Results: On postoperative day 3, the transfusion rate was significantly lower in the TXA group compared to the NS group, although mean hemoglobin and hematocrit levels were not significantly different between the two groups. However, the estimated hidden blood loss volume (210.09 ± 202.14 mL vs. 359.35 ± 290.12 mL; P < 0.05) and total blood loss volume (279.35 ± 209.11 mL vs. 417.89 ± 289.56 mL; P < 0.05) were significantly less in the TXA group compared to the NS group, respectively.

Conclusion: TXA significantly reduced postoperative hidden blood loss in patients with intertrochanteric fracture who underwent PFNA. (Registration number: ChiCTR-INR-16008134).

Keywords: Fracture; Hidden blood loss; Intertrochanteric femora; PFNA; Randomized controlled trial; Tranexamic acid.

Conflict of interest statement

Ethics approval and consent to participate

The experimental protocol was established according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of the Department of Department of Orthopedic Trauma, Xi’an Honghui Hospital, Xi’an Jiaotong University Health Science Center, China.

Consent for publication

Written informed consent was obtained from individual participants.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of patient enrollment

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