ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023
Does tranexamic acid reliably reduce blood loss in proximal femur fracture surgery?
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 11 citations in OpenAlex.
- Efficacy of Tranexamic Acid in a Large Population with Proximal Femur Fractures-A Matched Pair Study of 7394 Patients from the Registry for Geriatric Trauma (ATR-DGU).Journal of clinical medicine · 2026Article
- Tranexamic acid: single topical application for femoral neck fractures treated with arthroplasty results in lowest blood loss.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Tranexamic acid in hip fracture repair surgery: safe and effective?Blood transfusion = Trasfusione del sangue · 2025Article
- Knowledge Mapping of Postoperative Complications Following Shoulder Arthroplasty.Orthopedic reviews · 2025Article
- Development and validation of a nomogram model for prolonged length of stay in spinal fusion patients: a retrospective analysis.BMC medical informatics and decision making · 2024Article
- The emerging role of tranexamic acid and its principal target, plasminogen, in skeletal health.Acta pharmaceutica Sinica. B · 2024Review
- [Treatment of proximal femoral fractures : Principles, tips and tricks].Unfallchirurgie (Heidelberg, Germany) · 2024Review
- Topical Use of Low-dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study.Orthopaedic surgery · 2024Article
- Anticoagulation management in elderly patients with proximal femur fractures - overview of current concepts.Innovative surgical sciences · 2023Review
- A comprehensive analysis of intraoperative factors associated with acute-on-chronic kidney injury in elderly trauma patients: blood loss as a key predictor.Aging clinical and experimental research · 2023Article
- Early Posttraumatic Antifibrinolysis Reduces Perioperative Hidden Blood Loss in Elderly Patients with an Intertrochanteric Fracture: A Randomized Controlled Trial.Journal of clinical medicine · 2023Article
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Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of our study was to investigate the use of tranexamic acid in patients with proximal femoral fractures and compare the total blood loss, transfusion rates, complications, and the application method.
methodsA retrospective single center cohort study (level I trauma center) with 1479 patients treated operatively for a proximal femoral fracture between January 2016 and June 2020 was performed. 1 g of tranexamic acid was applied (systemic, topic or combined application). Patient data, surgical procedure, complications, and mortality were assessed. Hemoglobin levels, blood loss and transfusion rates for patients with and without tranexamic acid and the application methods were compared.
results667 femoral neck fractures, 701 pertrochanteric and 109 subtrochanteric fractures were included. Mean age was 80.8 years. 274 patients received tranexamic acid. At admission average hemoglobin was 12.2 g/l. Hemoglobin drop postoperatively was less after tranexamic acid (9.72 vs. 9.35 g/dl). Transfusion rates were lowered significantly by 17.1% after tranexamic acid. Blood loss was reduced for all patients after tranexamic acid independent of fracture morphology. The combination of 1 g i.v. and 1 g topical-applied tranexamic acid seems to be more effective. Complication rates did not differ.
conclusionTranexamic acid is effective in reducing blood loss and transfusion rates, without increasing the risk of thromboembolic events after proximal femoral fractures. For open reduction and nailing and arthroplasty in fracture setting combined topical and single i.v. application seems most effective and closed reduction with nailing can be treated by single dose i.v. application of 1 g tranexamic acid.
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