Interaction of preoperative chemoprophylaxis and tranexamic acid use does not affect transfusion in acetabular fracture surgery.
Eur J Orthop Surg Traumatol
; 34(2): 1025-1029, 2024 Feb.
Article
en En
| MEDLINE
| ID: mdl-37865628
ABSTRACT
PURPOSE:
While the effects of tranexamic acid (TXA) use on transfusion rates after acetabular fracture surgery are unclear, previous evidence suggests that holding deep vein thrombosis (DVT) chemoprophylaxis may improve TXA efficacy. This study examines whether holding DVT chemoprophylaxis in patients receiving TXA affects intraoperative and postoperative transfusion rates in acetabular fracture surgery.METHODS:
We reviewed electronic medical records (EMR) of 305 patients who underwent open reduction and internal fixation of acetabular fractures (AO/OTA 62) and stratified patients per the following perioperative treatment (1) no intraoperative TXA (noTXA), (2) intraoperative TXA and no preoperative DVT prophylaxis (opTXA/noDVTP), or (3) intraoperative TXA and preoperative DVT prophylaxis (opTXA/opDVTP). The primary outcomes were need for intraoperative or postoperative transfusion. Risk factors for each primary outcome were assessed using multivariable regression.RESULTS:
Intraoperative or postoperative transfusion rates did not significantly differ between opTXA/opDVTP and opTXA/noDVTP groups (46.2% vs. 36%, p = 0.463; 15.4% vs. 28%, p = 0.181). Median units transfused did not differ between groups (2 ± 1 vs. 2 ± 1, p = 0.515; 2 ± 1 vs. 2 ± 0, p = 0.099). There was no association between preoperative DVT chemoprophylaxis and TXA with intraoperative or postoperative transfusions. EBL, preoperative hematocrit, and IV fluids were associated with intraoperative transfusions; age and Charlson Comorbidity Index (CCI) were associated with postoperative transfusions.CONCLUSION:
Our findings suggest holding DVT prophylaxis did not alter the effect of TXA on blood loss or need for transfusion.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Ácido Tranexámico
/
Fracturas de Cadera
/
Antifibrinolíticos
Límite:
Humans
Idioma:
En
Revista:
Eur J Orthop Surg Traumatol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos