Evidence map›Paper›PMID 25116268›Full record

ArticleBMJ (Clinical research ed.)2014

Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety.

Jashvant Poeran, Rehana Rasul, Suzuko Suzuki, Thomas Danninger, Madhu Mazumdar, Mathias Opperer, Friedrich Boettner, Stavros G Memtsoudis

5 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 166 papers, 23 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
166citing papers in PubMed, 23 pooled it
20.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02753816 naterminatednot on this mapstarted 2016, after this paper: background citation

The Effect of Tranexamic Acid (TXA) on Blood Loss and Transfusion Rates in Burn Wound Surgery - A Randomized, Double-Blinded Placebo-Controlled Trial

TypeinterventionalSponsorCorewell Health WestRan2016 to 2019Enrolled25ConditionsTranexamic Acid, Burn, Major SurgeryArmsTranexamic Acid, Placebo Comparator
NCT02947529 phase4completednot on this mapstarted 2015, after this paper: background citation

The Use of Tranexamic Acid to Reduce the Need for Transfusion 1 Week Post-operatively for Hemiarthroplasty or Intramedullary Nailing Needed to Correct Acute Hip Fractures

TypeinterventionalSponsorCarilion ClinicRan2015 to 2022Enrolled113ConditionsAcute Hip FracturesArmsTranexamic Acid, Placebo
NCT03359525 phase4unknown statusnot on this mapstarted 2017, after this paper: background citation

Prospective Randomized Study Comparing Topical Versus Intravenous Tranexamic Acid in Anterior Total Hip Arthroplasty

TypeinterventionalSponsorAlbany Medical CollegeRan2017 to 2019Enrolled114ConditionsTranexamic Acid Adverse ReactionArmsTranexamic Acid
NCT03690037 phase4completednot on this mapstarted 2016, after this paper: background citation

Single Centre Randomised Controlled Trial to Assess the Effect of the Addition of Twenty-four Hours of Oral Tranexamic Acid Post-operatively to a Single Intra-operative Intravenous Dose of Tranexamic Acid on Calculated Blood Loss Following Primary Hip and Knee Arthroplasty.

TypeinterventionalSponsorBelfast Health and Social Care TrustRan2016 to 2019Enrolled1,089ConditionsPrimary Total Knee Arthroplasty, Primary Total Hip ArthroplastyArmsTranexamic Acid 100 MG/ML, Tranexamic Acid 500 MG
NCT04630886 early_phase1terminatednot on this mapstarted 2021, after this paper: background citation

Local Injection of Tranexamic Acid May Reduce Bleeding, Injection Pain, and Other Post-op Complications During Mohs Micrographic Surgery

TypeinterventionalSponsorRiley McLeanRan2021 to 2024Enrolled34ConditionsSkin NeoplasmsArmsTranexamic acid injection, Lidocaine Epinephrine
3 · Its place in the literature

Who cites it

166 citing papers in PubMed, 23 syntheses or guidelines pooled it, 457 citations in OpenAlex.

  1. Efficacy and safety of Tranexamic acid use on postoperative blood transfusion in hip fracture patients- a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
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  2. Tranexamic acid for preventing postpartum haemorrhage after vaginal birth.The Cochrane database of systematic reviews · 2025
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  5. Tranexamic acid for percutaneous nephrolithotomy.The Cochrane database of systematic reviews · 2023
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  6. Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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  18. Tranexamic Acid Use in Prehospital Uncontrolled Hemorrhage.Wilderness & environmental medicine · 2017
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106 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Jashvant PoeranInstitute of Healthcare Delivery Science, Mount Sinai Hospital System / Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Rehana RasulInstitute of Healthcare Delivery Science, Mount Sinai Hospital System / Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Suzuko SuzukiDepartment of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
Thomas DanningerDepartment of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
Madhu MazumdarInstitute of Healthcare Delivery Science, Mount Sinai Hospital System / Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Mathias OppererDepartment of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
Friedrich BoettnerDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Stavros G MemtsoudisDepartment of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA memtsoudiss@hss.edu.
Hospital for Special Surgery · USMount Sinai Health System · USIcahn School of Medicine at Mount Sinai · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effectiveness and safety of perioperative tranexamic acid use in patients undergoing total hip or knee arthroplasty in the United States.

designRetrospective cohort study; multilevel multivariable logistic regression models measured the association between tranexamic acid use in the perioperative period and outcomes.

setting510 US hospitals from the claims based Premier Perspective database for 2006-12.

participants872,416 patients who had total hip or knee arthroplasty.

interventionPerioperative intravenous tranexamic acid use by dose categories (none, ≤ 1000 mg, 2000 mg, and ≥ 3000 mg).

main outcome measuresAllogeneic or autologous transfusion, thromboembolic complications (pulmonary embolism, deep venous thrombosis), acute renal failure, and combined complications (thromboembolic complications, acute renal failure, cerebrovascular events, myocardial infarction, in-hospital mortality).

resultsWhile comparable regarding average age and comorbidity index, patients receiving tranexamic acid (versus those who did not) showed lower rates of allogeneic or autologous transfusion (7.7% v 20.1%), thromboembolic complications (0.6% v 0.8%), acute renal failure (1.2% v 1.6%), and combined complications (1.9% v 2.6%); all P<0.01. In the multilevel models, tranexamic acid dose categories (versus no tranexamic acid use) were associated with significantly (P<0.001) decreased odds for allogeneic or autologous blood transfusions (odds ratio 0.31 to 0.38 by dose category) and no significantly increased risk for complications: thromboembolic complications (odds ratio 0.85 to 1.02), acute renal failure (0.70 to 1.11), and combined complications (0.75 to 0.98).

conclusionsTranexamic acid was effective in reducing the need for blood transfusions while not increasing the risk of complications, including thromboembolic events and renal failure. Thus our data provide incremental evidence of the potential effectiveness and safety of tranexamic acid in patients requiring orthopedic surgery.

Indexed as

AdultAgedAntifibrinolytic AgentsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBlood Loss, SurgicalBlood TransfusionDatabases, FactualFemaleHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPulmonary EmbolismStatistics as TopicAntifibrinolytic AgentsTranexamic Acid

Identifiers

PMID25116268
PMCPMC4130961
OpenAlexW2128863777

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.