Cargando…
Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis
AIM: The aim of this meta-analysis was to assess the safety and efficacy of tranexamic acid (TXA) in the management of hip fracture surgeries in comparison with placebo. METHODS: A systematic search was conducted from August 6, 2021. Eligible studies included randomized clinical trials and prospecti...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Paris
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275812/ https://www.ncbi.nlm.nih.gov/pubmed/36156738 http://dx.doi.org/10.1007/s00590-022-03387-9 |
_version_ | 1785059948645842944 |
---|---|
author | Miangul, Shahid Oluwaremi, Timothy El Haddad, Joe Adra, Maamoun Pinnawala, Nathan Nakanishi, Hayato Matar, Reem H. Than, Christian A. Stewart, Thomas M. |
author_facet | Miangul, Shahid Oluwaremi, Timothy El Haddad, Joe Adra, Maamoun Pinnawala, Nathan Nakanishi, Hayato Matar, Reem H. Than, Christian A. Stewart, Thomas M. |
author_sort | Miangul, Shahid |
collection | PubMed |
description | AIM: The aim of this meta-analysis was to assess the safety and efficacy of tranexamic acid (TXA) in the management of hip fracture surgeries in comparison with placebo. METHODS: A systematic search was conducted from August 6, 2021. Eligible studies included randomized clinical trials and prospective studies comparing the use of intravenous TXA in patients treated for hip fractures, in comparison with placebo. Review Manager was used for the meta-analysis. RESULTS: Eighteen prospective studies including 14 RCTs met the eligibility criteria. The results favored the TXA group in the quantity of total blood loss (MD = − 196.91 mL, 95% CI − 247.59, − 146.23, I(2) = 92%), intraoperative blood loss (MD = − 26.86 mL, 95% CI − 36.96, − 16.78, I(2) = 62%), and rate of blood transfusion (OR 0.35, 95% CI 0.28, 0.42, I(2) = 0%). TXA also exhibited higher hemoglobin level at day 1 (MD = 6.77 g/L, 95% CI 4.30, 9.24, I(2) = 83%) and day 3 (MD = 7.02 g/L, 95% CI 3.30, 10.74, I(2) = 82%) postoperatively. There was no significant difference found in the incidence of thromboembolic events from occurring between the two groups, such as deep vein thrombosis (OR 1.22, 95% CI 0.73, 2.02, I(2) = 0%) and pulmonary embolism (OR 0.82, 95% CI 0.33, 2.05, I(2) = 0%). CONCLUSION: Administration of intravenous TXA appears to reduce blood loss, rate of blood transfusions and pose no increased risk of thromboembolic events. Therefore, TXA should be considered by physicians when managing hip fracture patients. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00590-022-03387-9. |
format | Online Article Text |
id | pubmed-10275812 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Paris |
record_format | MEDLINE/PubMed |
spelling | pubmed-102758122023-06-18 Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis Miangul, Shahid Oluwaremi, Timothy El Haddad, Joe Adra, Maamoun Pinnawala, Nathan Nakanishi, Hayato Matar, Reem H. Than, Christian A. Stewart, Thomas M. Eur J Orthop Surg Traumatol Up-to date Review and Case Report AIM: The aim of this meta-analysis was to assess the safety and efficacy of tranexamic acid (TXA) in the management of hip fracture surgeries in comparison with placebo. METHODS: A systematic search was conducted from August 6, 2021. Eligible studies included randomized clinical trials and prospective studies comparing the use of intravenous TXA in patients treated for hip fractures, in comparison with placebo. Review Manager was used for the meta-analysis. RESULTS: Eighteen prospective studies including 14 RCTs met the eligibility criteria. The results favored the TXA group in the quantity of total blood loss (MD = − 196.91 mL, 95% CI − 247.59, − 146.23, I(2) = 92%), intraoperative blood loss (MD = − 26.86 mL, 95% CI − 36.96, − 16.78, I(2) = 62%), and rate of blood transfusion (OR 0.35, 95% CI 0.28, 0.42, I(2) = 0%). TXA also exhibited higher hemoglobin level at day 1 (MD = 6.77 g/L, 95% CI 4.30, 9.24, I(2) = 83%) and day 3 (MD = 7.02 g/L, 95% CI 3.30, 10.74, I(2) = 82%) postoperatively. There was no significant difference found in the incidence of thromboembolic events from occurring between the two groups, such as deep vein thrombosis (OR 1.22, 95% CI 0.73, 2.02, I(2) = 0%) and pulmonary embolism (OR 0.82, 95% CI 0.33, 2.05, I(2) = 0%). CONCLUSION: Administration of intravenous TXA appears to reduce blood loss, rate of blood transfusions and pose no increased risk of thromboembolic events. Therefore, TXA should be considered by physicians when managing hip fracture patients. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00590-022-03387-9. Springer Paris 2022-09-26 2023 /pmc/articles/PMC10275812/ /pubmed/36156738 http://dx.doi.org/10.1007/s00590-022-03387-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Up-to date Review and Case Report Miangul, Shahid Oluwaremi, Timothy El Haddad, Joe Adra, Maamoun Pinnawala, Nathan Nakanishi, Hayato Matar, Reem H. Than, Christian A. Stewart, Thomas M. Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
title | Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
title_full | Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
title_fullStr | Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
title_full_unstemmed | Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
title_short | Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
title_sort | update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis |
topic | Up-to date Review and Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275812/ https://www.ncbi.nlm.nih.gov/pubmed/36156738 http://dx.doi.org/10.1007/s00590-022-03387-9 |
work_keys_str_mv | AT miangulshahid updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT oluwaremitimothy updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT elhaddadjoe updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT adramaamoun updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT pinnawalanathan updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT nakanishihayato updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT matarreemh updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT thanchristiana updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis AT stewartthomasm updateontheefficacyandsafetyofintravenoustranexamicacidinhipfracturesurgeryasystematicreviewandmetaanalysis |