Institutions | About Us | Help | Gaeilge
rian logo


Mark
Go Back
Cost benefit analysis of the use of tranexamic acid in primary lower limb arthroplasty: a retrospective cohort study
McGoldrick, Niall P; O'Connor, Eabhann M; Davarinos, Nikos; Galvin, Rose; Quinlan, John F
AIM: To examine the cost benefit conferred by the perioperative administration of intravenous tranexamic acid (TXA) in lower limb arthroplasty. METHODS: This study evaluates the use of TXA in 200 consecutive lower limb arthroplasties performed in a single surgeon series. The initial 100 patients (control group) underwent surgery without perioperative administration of TXA while the subsequent 100 patients (TXA group) all received 1 g TXA at the time of induction of anaesthesia. Pre- and post-operative haemoglobin, platelet count, haematocrit, the use of blood product post-operatively, length of stay were examined. A financial analysis of both groups was then undertaken. RESULTS: The mean age of patients in both groups was 63 +/- 13 years. There were no significant differences between groups in terms of gender (P = 0.47), proportion of total hip replacement to total knee replacement (P = 0.25) or pre-operative haemoglobin (P = 0.43). In the control group, the transfusion rate was 22%. In the TXA group, the transfusion rate dropped to 2% (P < 0.001). The mean post-operative haemoglobin was 10.82 +/- 1.55 g/dL in the control group vs 11.33 +/- 1.27 g/dL in the TXA group (P = 0.01). The total cost of transfused blood products was euro11055 and euro603 respectively. The mean length of stay in the control group was 6.53 +/- 5.93 d vs 5.47 +/- 4.26 d in the TXA group (P = 0.15) leading to an estimated financial saving of euro114586. There was one pulmonary embolus in the control group and one deep venous thrombosis in the TXA group. CONCLUSION: Intravenous TXA reduces blood loss in lower limb arthroplasty. This leads to lower transfusion rates, shorter length of stay in hospital and significant financial savings.AIM: To examine the cost benefit conferred by the perioperative administration of intravenous tranexamic acid (TXA) in lower limb arthroplasty. METHODS: This study evaluates the use of TXA in 200 consecutive lower limb arthroplasties performed in a single surgeon series. The initial 100 patients (control group) underwent surgery without perioperative administration of TXA while the subsequent 100 patients (TXA group) all received 1 g TXA at the time of induction of anaesthesia. Pre- and post-operative haemoglobin, platelet count, haematocrit, the use of blood product post-operatively, length of stay were examined. A financial analysis of both groups was then undertaken. RESULTS: The mean age of patients in both groups was 63 +/- 13 years. There were no significant differences between groups in terms of gender (P = 0.47), proportion of total hip replacement to total knee replacement (P = 0.25) or pre-operative haemoglobin (P = 0.43). In the control group, the transfusion rate was 22%. In the TXA group, the transfusion rate dropped to 2% (P < 0.001). The mean post-operative haemoglobin was 10.82 +/- 1.55 g/dL in the control group vs 11.33 +/- 1.27 g/dL in the TXA group (P = 0.01). The total cost of transfused blood products was euro11055 and euro603 respectively. The mean length of stay in the control group was 6.53 +/- 5.93 d vs 5.47 +/- 4.26 d in the TXA group (P = 0.15) leading to an estimated financial saving of euro114586. There was one pulmonary embolus in the control group and one deep venous thrombosis in the TXA group. CONCLUSION: Intravenous TXA reduces blood loss in lower limb arthroplasty. This leads to lower transfusion rates, shorter length of stay in hospital and significant financial savings. PUBLISHED peer-reviewed
Keyword(s): athroplasty; cost-benefit analysis; hip; knee; tranexamic acid
Publication Date:
2015
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University of Limerick
Citation(s): World Journal of Orthopedics;18, 6 (11), pp. 977-982
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686445/pdf/WJO-6-977.pdfhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686445/pdf/WJO-6-977.pdf
Publisher(s): Baishideng Publishing Group Inc
First Indexed: 2016-04-02 05:26:00 Last Updated: 2016-04-02 05:26:00