Abstract

EFFICACY OF TRANEXAMIC ACID TO REDUCE HEMORRHAGE AND BLOOD TRANSFUSION IN MAJOR ORTHOPEDIC SURGERIES: A META-ANALYSIS

Abdullah Ali Altulihi*, Mohamed Mahmoud Aljondi, Maali Omar Abdulrahman Alrashed, Saleh Abdulrahman Alrusayni, Abdulmajeed Ahmed Medawi Assiri, Mubark Hamed Alsharari, Ali Saad Alshahrani, Abdullatef Ahmad Alenzi, Ahmed Abdulrahman Baghdadi, Maan Alnour Almahi, Ibrahim Tareq Amer

Abstract

Background & Purpose: The Tranexamic Acid (TXA) has been used successfully to prevent bleeding in more than one specialty along with liver, cardiac, prostate, and dental surgeries. The Aim of this work is to provide cumulative data about the efficacy of tranexamic acid (TXA) to reduce hemorrhage and blood transfusion in major orthopedic surgeries. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Orthopedic surgery RCTs, clinical trials, and comparative studies, which studied the outcome of TXA group versus Control group of orthopedic surgery patients. A meta- analysis was done using fixed and random-effect methods. Primary outcome was total blood loss. Secondary outcomes were intra and post-operative amount of blood loss. Results: A total of 7 studies were identified involving 557 patients, with 287 patients in TXA group, and 270 patients in Control group. Regarding primary outcome measures, random-effects model of the meta-analysis study showed highly significant decrease in mean total blood loss in TXA group (p < 0.01). Regarding secondary outcome measures, random-effects model of the meta- analysis study showed significant decrease in mean intra-operative blood loss in TXA group (p < 0.05). The random-effects model of the meta-analysis study showed non-significant difference in mean post-operative blood loss (p > 0.05). Conclusion: To conclude, TXA significantly decreases blood loss and blood transfusion requirements in patients undergoing orthopedic surgery.

Keywords: TXA, Hemorrhage, Orthopedic Surgery.