Evidence map›Paper›PMID 40192873›Full record

SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Efficacy and safety of Tranexamic acid use on postoperative blood transfusion in hip fracture patients- a systematic review and meta-analysis.

Christian A Klingemann, Jes B Lauritzen, Henrik L Jørgensen

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. 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

3 authors.

Christian A KlingemannUniversity of Copenhagen, Blegdamsvej 3B, 2200 KBH N, Copenhagen, Denmark.
Jes B LauritzenDepartment of Orthopedic Surgery, Bispebjerg Hospital, KBH NV, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark.
Henrik L JørgensenDepartment of Clinical Biochemistry, Hvidovre Hospital, Kettegård Alle 30, Hvidovre, 2650, Denmark. hlj@dadlnet.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review seeks to investigate whether tranexamic acid (TXA) should be administered to patients over 65 years of age undergoing hip fracture surgery. This select patient population is at increased risk of requiring red blood cell transfusions, why there might be a case for TXA intervention.

methodsFollowing PRISMA guidelines, a systematic search was conducted on EMBASE and PubMed databases on the 27th of November 2023. Only randomized controlled trials (RCT) with a mean age of above 65 years where eligible for inclusion. Only studies with intravenous intervention and control with saline were included. A Cochrane Risk of Bias tool was used to investigate potential biases. The certainty of each outcome was interpreted using the GRADE approach. The primary outcome was red blood cell transfusion rate and the secondary outcome was thromboembolic event rate.

resultsThis review comprised of 12 RCTs with a combined 1397 patients, of whom 699 received TXA and 698 received saline. Pooled results show a significant reduction in blood transfusion rate for patients who received TXA (RR 0.612, 95%CI 0.480-0.779, p-value < 0.001). Thromboembolic event rate was reported in 9 studies, tallying 1147 patients. Results showed no significant change in thromboembolic event rate for patients receiving TXA intervention (RR 0.922, 95%CI 0.603-1.411, p-value = 0.710).

conclusionTranexamic acid significantly reduced the need for blood transfusion in patients undergoing hip fracture surgery. Furthermore, no significant change in thromboembolic events is present, but due to low thromboembolic event rate in the patient population, no definite conclusion can be made regarding the safety of tranexamic acid. Furthermore, a higher grade of homogeneity between studies with regards to TXA intervention timing and dose would be helpful. In conclusion, intervention with TXA appears promising with regards to transfusion requirement in the targeted population.

Indexed as

Antifibrinolytic AgentsBlood TransfusionHip FracturesPostoperative HemorrhageTranexamic AcidAgedBlood Loss, SurgicalErythrocyte TransfusionHumansRandomized Controlled Trials as TopicThromboembolismAntifibrinolytic AgentsTranexamic AcidBlood transfusionHip fractureTranexamic acidTransfusion rate

Identifiers

PMID40192873

What OpenQuestion holds

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Registered trials

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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.