March 10, 2022
Cell salvage and tranexamic acid are used in total hip arthroplasty to reduce allogeneic blood transfusions. This study aimed to determine the effect of tranexamic acid used before surgery on the volume of intraoperative and postoperative allogeneic blood transfusions, hospital costs, and postoperative complications in geriatric patients undergoing total hip arthroplasty by comparing it with that of the cell salvage and control treatment.
Materials and Methods:
The data of 1408 patients in who underwent primary total hip arthroplasty at a single center between January 2012 and October 2021 were retrospectively analyzed. Patients were classified into three groups according to the treatment used cell salvage (n=227), tranexamic acid (n=485), and control treatment (n=533). Blood loss, volume of allogeneic blood transfused, hospitalization, cost parameters and thromboembolic complication rates were evaluated.
Patients in the TXA group received the least volume of blood transfusions during the intraoperative and postoperative periods (p=0.001, p=0.004 respectively). The volume of autologous blood transfusion in the cell salvage group was similar to the volume allogeneic blood transfusions in the tranexamic acid group (p=0.92). The cost was significantly lower in the tranexamic acid group (p<0.001), whereas it was significantly higher in the cell salvage group compared to that in the other groups. Conclusion:
In total hip arthroplasty, a common procedure in the geriatric population, preoperative use of tranexamic acid is associated with less intraoperative and postoperative blood loss, less allogeneic blood transfusion, and lower hospital costs, without increasing the risk of thromboembolic events.
Keywords: Tranexamic acid, operative blood salvage, arthroplasty, hip, cost-benefit analysis.