Abstract
Aims: We chose unstable extra-capsular hip fractures as our study group because these types of fractures suffer the largest blood loss. We hypothesised that tranexamic acid (TXA) would reduce total blood loss (TBL) in extra-capsular fractures of the hip. Patients and Methods: A single-centre placebo-controlled double-blinded randomised clinical trial was performed to test the hypothesis on patients undergoing surgery for extra-capsular hip fractures. For reasons outside the control of the investigators, the trial was stopped before reaching the 120 included patients as planned in the protocol. Results: In all 72 patients (51 women, 21 men; 33 patients in the TXA group, 39 in the placebo group) were included in the final analysis, with a significant mean reduction of 570.8 ml (p = 0.029) in TBL from 2100.4 ml (standard deviation (SD) = 1152.6) in the placebo group to 1529.6 ml (SD = 1012.7) in the TXA group. The 90-day mortality was 27.2% (n = 9) in the TXA group and 10.2% (n = 4) in the placebo group (p = 0.07). We were not able to ascertain a reliable cause of death in these patients. Discussion: TXA significantly reduced TBL in extra-capsular hip fractures, but concerns regarding its safety in this patient group must be investigated further before the use of TXA can be recommended.
| Original language | English |
|---|---|
| Journal | The Bone & Joint Journal |
| Volume | 98-B |
| Issue number | 6 |
| Pages (from-to) | 747-53 |
| Number of pages | 7 |
| ISSN | 0301-620X |
| DOIs | |
| Publication status | Published - Jun 2016 |
Keywords
- Aged
- Antifibrinolytic Agents
- Blood Loss, Surgical
- Blood Transfusion
- Denmark
- Double-Blind Method
- Early Termination of Clinical Trials
- Female
- Fracture Fixation, Intramedullary
- Hemoglobins
- Hip Fractures
- Hospital Mortality
- Humans
- Male
- Tranexamic Acid
- Journal Article
- Randomized Controlled Trial