Evidence map›Paper›PMID 38847833›Full record

Trial reportArchives of orthopaedic and trauma surgery2024

A randomised controlled trial assessing the effect of tranexamic acid on post-operative blood transfusions in patient with intra-capsular hip fractures treated with hemi- or total hip arthroplasty.

Yasser Khatib, Gobind Bal, Rui Liu, Wagdy Ashaia, Rami Sorial

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. 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 · 2025
    Article
  5. Tranexamic acid in hip fracture repair surgery: safe and effective?Blood transfusion = Trasfusione del sangue · 2025
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yasser KhatibNepean Hospital, The School of Medicine Nepean, The University of Sydney, PO Box 949, Penrith, NSW, 2750, Australia. yasser@carefirstortho.com.au.ORCID http://orcid.org/0000-0002-4991-5872
Gobind BalNepean Hospital, Derby St, Kingswood, NSW, 2747, Australia.
Rui LiuNepean Hospital, Kingswood, NSW, Australia.
Wagdy AshaiaNepean Hospital, Derby St, Kingswood, NSW, 2747, Australia.
Rami SorialNepean Hospital, The School of Medicine Nepean, The University of Sydney, PO Box 949, Penrith, NSW, 2750, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntravenous tranexamic acid (TA) has proven efficacy in reducing blood loss and incidence of transfusion of blood products in elective total joint arthroplasty. However, evidence of efficacy in the setting of intracapsular hip fractures needing hip hemiarthroplasty (HA) or total hip arthroplasty (THA) are scarce. This study aimed to assess post-operative transfusion incidence in this clinical setting.

methodsOver a five-year period 250 patients with intracapsular neck of femur fractures requiring arthroplasty were randomised to two groups. The treatment group received three-dose intravenous TA protocol and the control group received usual treatment without administration of TA. Blood loss was estimated from the change in Hb levels on day 1, 3 and 5 after surgery compared to preoperative levels. Transfusions of blood products were recorded when they were triggered by an a priori protocol. Post-operative complications were recorded during patient hospital admission.

resultsThe intervention group showed significantly lower transfusion incidence of packed red blood cells (PRBC) (6 vs. 15, p = 0.04, OR = 0.37, 95%CI OR = 0.14 to 0.99) and in the group of patients who received a blood transfusion, a trend was observed for patients who received TA to have lesser number of units of PRBC (mean = 1.3 vs. 1.6, p = 0.51). A significant difference was noted in post-operative Hb levels of day 1,3 and 5. Backward stepwise multivariable regression analysis showed the use of TA was the most significant factor for reduction in postoperative blood transfusion (p = 0.047, OR = 0.37, 95% CI OR = 0.14 to 0.99). Assessment of the strength of the correlation showed modest correlation (Pearson correlation - 0.13 p = 0.04, 95% CI correlation= -0.25 to -0.01). There was no increase in adverse events in patients who received TA.

conclusionThe use of TA in setting of intracapsular hip fractures requiring arthroplasty reduces blood loss, the need for transfusion of blood products and may reduce surgical site complications without increasing the risk of VTE.

Indexed as

Antifibrinolytic AgentsArthroplasty, Replacement, HipBlood Loss, SurgicalBlood TransfusionHemiarthroplastyHip FracturesTranexamic AcidAgedAged, 80 and overFemaleFemoral Neck FracturesHumansMaleMiddle AgedPostoperative HemorrhageAntifibrinolytic AgentsTranexamic AcidBlood transfusionHip arthroplastyNeck of femur fractureTranexamic acidVenous thromboembolism

Identifiers

PMID38847833

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.