A meta-analysis of tranexamic acid to reduce blood loss in total hip arthroplasty

doi:10.3969/j.issn.2095-4344.2014.17.022

Abstract

Abstract:

BACKGROUND: Tranexamic acid is a synthetic derivative of lysine, it can reversibly block the lysine binding sites on plasmin and plasminogen, thus playing anti-fibrinolytic effect. Tranexamic acid has been widely used in the treatment of cardiovascular surgery and is proven to effectively reduce blood loss.
OBJECTIVE: To evaluate the effectiveness and safety of tranexamic acid treatment on reducing blood loss in total hip arthroplasty through a meta-analysis.
METHODS: An online retrieval of Medline, PubMed, EMBASE, Cochrane Library, CNKI and VIP databases before September 2013 was performed for screening randomized controlled trials about the effect of tranexamic acid on blood loss in total hip arthroplasty. Meanwhile the references of the included literatures were manually checked. Statistical analysis was performed using RevMan5.0 software. The blood loss volume and blood transfusion volume in tranexamic acid group and placebo group were evaluated using the weighted mean difference. The incidence of transfusion rate and deep vein thrombosis were calculated using risk ratio in two groups.
RESULTS AND CONCLUSION: A total of 16 randomized controlled trials involving 884 patients were included. Meta-analysis results showed that, tranexamic acid reduced total blood loss of patients after total hip arthroplasty, by a mean of 261.42 mL (95%CI -334.25 to -188.59, P < 0.000 01), intraoperative blood loss by a mean of 135.04 mL (95%CI -223.31 to -46.77, P < 0.01) and postoperative blood loss by a mean of 159.70 mL (95%CI -217.06 to -102.34, P < 0.000 01). Tranexamic acid also led to a significant reduction in transfusion requirements (RR 0.46, 95%CI 0.36 to 0.59, P < 0.000 01). There was no significant difference in the risk of deep vein thrombosis between the two groups. Tranexamic acid significantly reduces blood loss and blood transfusion requirements in patients undergoing total hip arthroplasty, and cannot increase the risk of deep vein thrombosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: tranexamic acid, arthroplasty, replacement, hip

CLC Number:

R318

Yin Yong, Ma Guang-wen, Huang Fei, Wang Qing, Wu Yun-feng. A meta-analysis of tranexamic acid to reduce blood loss in total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(17): 2752-2757.

Figures/Tables 6

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