Tranexamic acid reduces blood loss in intertrochanteric fractures: A meta-analysis from randomized controlled trials

BACKGROUND: This meta-analysis aims to assess the efficacy and safety of tranexamic acid for reducing blood loss and transfusion requirements in patients with intertrochanteric fractures. METHODS: We conduct electronic searches of Medline (1966–2017.09), PubMed (1966–2017.09), Embase (1980–2017.09), ScienceDirect (1985–2017.09), and the Cochrane Library. Only randomized controlled trials (RCTs) are included. The quality assessments are performed according to the Cochrane systematic review method. Fixed/random-effect model is used according to the heterogeneity tested by I(2) statistic. Meta-analysis is performed using Stata 11.0 software. RESULTS: A total of 4 RCTs are retrieved involving 514 participants. The present meta-analysis indicated that there were significant differences between groups in terms of total blood loss (weighted mean differences = −131.49, 95% confidence interval (CI): −163.63 to −99.35, P = .00), hemoglobin decline (weighted mean differences = −0.31, 95% CI, −0.44 to −0.19, P = .00), and transfusion rate (risk differences = −1.11, 95% CI, −0.19 to −0.04, P = .00). In addition, no increased risk of adverse effects was identified in both groups. CONCLUSION: Local administration of tranexamic acid is associated with a reduced total blood loss, postoperative hemoglobin decline, and transfusion requirements in patients with intertrochanteric fractures. High-quality RCTs are still required for further investigation.