Tranexamic Acid Use in Acute Hip Fractures
| Status: | Completed |
|---|---|
| Conditions: | Orthopedic, Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 65 - Any |
| Updated: | 9/22/2017 |
| Start Date: | August 2015 |
| End Date: | August 31, 2017 |
The Use of Tranexamic Acid to Reduce the Need for Transfusion 1 Week Post-operatively for Hemiarthroplasty or Intramedullary Nailing Needed to Correct Acute Hip Fractures
BACKGROUND: Tranexamic acid (TXA) has been used widely for the reduction of post operative
blood loss for various orthopaedic procedures including but not limited to total hip
arthroplasty and total knee arthroplasty. A recent multihospital meta-analysis conducted in
2013 showed that patients who received TXA showed a significant reduction in post-operative
transfusion (20.1% to 7.7%). The procedures the investigators will be evaluating are the
intramedullary nail for intertrochanteric fracture and hip hemiarthroplasty. These procedures
are similar to the total hip or knee replacement in that they can result in significant blood
loss that requires a post operative transfusion.
STUDY PURPOSE: To determine the efficacy of TXA to decrease the rate of post-operative
transfusion for acute hip fractures repaired with the following two methods, intramedullary
nailing for intertrochanteric fracture and hemiarthroplasty.
METHODS: The model for the study is a prospective randomized control trial. Patients will be
placed in one of two arms of the study after passing our inclusion criteria. The arms will be
for either the intramedullary nailing for intertrochanteric fracture or for hemiarthroplasty.
These two categories will be subdivided into those receiving TXA and those not receiving TXA.
The patients in each category will have standard post-operative care and laboratory testing.
The investigators will record the patients in either arm of the study, whether it be no TXA
or TXA, who require post-operative transfusion within 1 week of the operation.
blood loss for various orthopaedic procedures including but not limited to total hip
arthroplasty and total knee arthroplasty. A recent multihospital meta-analysis conducted in
2013 showed that patients who received TXA showed a significant reduction in post-operative
transfusion (20.1% to 7.7%). The procedures the investigators will be evaluating are the
intramedullary nail for intertrochanteric fracture and hip hemiarthroplasty. These procedures
are similar to the total hip or knee replacement in that they can result in significant blood
loss that requires a post operative transfusion.
STUDY PURPOSE: To determine the efficacy of TXA to decrease the rate of post-operative
transfusion for acute hip fractures repaired with the following two methods, intramedullary
nailing for intertrochanteric fracture and hemiarthroplasty.
METHODS: The model for the study is a prospective randomized control trial. Patients will be
placed in one of two arms of the study after passing our inclusion criteria. The arms will be
for either the intramedullary nailing for intertrochanteric fracture or for hemiarthroplasty.
These two categories will be subdivided into those receiving TXA and those not receiving TXA.
The patients in each category will have standard post-operative care and laboratory testing.
The investigators will record the patients in either arm of the study, whether it be no TXA
or TXA, who require post-operative transfusion within 1 week of the operation.
Inclusion Criteria:
- Geriatric patients age 65 or older who require surgery for a low energy trauma hip
fracture
Exclusion Criteria:
- Prothrombotic state
- Cardiac stent within the past year with corresponding antiplatelet therapy
- Mechanical heart valves
- Deep vein thrombosis history
- Aortic stenosis
- Currently on Coumadin
- Malignancy
- Kidney dialysis
- Non-English speaking patients
- Medications contraindicated with tranexamic acid.
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