ALEXANDRU PATRASCU, OLIVERA LUPESCU,  LILIANA SAVIN, DAN MIHAILESCU, CARMEN GRIEROSU, DANA NICOLETA MIHAI, VICTOR GRIGORESCU, PAUL BOTEZ<br>Tranexamic Acid vs Autologous Reinfusion Drain <br>in Primary  HIP Arthroplasty A retrospective cohort study

ALEXANDRU PATRASCU, OLIVERA LUPESCU, LILIANA SAVIN, DAN MIHAILESCU, CARMEN GRIEROSU, DANA NICOLETA MIHAI, VICTOR GRIGORESCU, PAUL BOTEZ
Tranexamic Acid vs Autologous Reinfusion Drain
in Primary HIP Arthroplasty A retrospective cohort study

Abstract:

Management of blood loss in primary hip arthroplasty is a controversial topic. Although the efficacy of tranexamic acid has been proven, there is still controversy regarding the efficacy of autologous reinfusion drains. The purpose of this study was to compare the efficacy of these two methods. We retrospectively reviewed a total of 246 randomized patients who underwent primary hip arthroplasty. The patients were divided into three groups: TNX group: single preoperative tranexamic acid dose and postoperative hemovac drain, ABRD group: did not receive tranexamic acid, but received a reinfusion drain, and C group: did not receive tranexamic acid but had a hemovac drain used postoperatively. The data collected for analysis were: demographic data, hemoglobin (Hb) variation preoperatively and at 12 and 24 h postoperatively, number of red blood cell units administered postoperatively, and postoperative complications. The mean Hb levels 12 h postoperatively decreased significantly in all groups (p = 0.001), without significant differences (p = 0.093). The mean Hb levels at 24 h postoperatively decreased significantly in all groups compared with the preoperative ones (p = 0.001), a significantly lower mean level being recorded in TNX compared to C or ABRD groups (p = 0.001). Our results showed a lower efficacy of ABRD compared to C (DHb24 C = 3.1mg/dL compared to DHb24 ABRD= 3.33 mg/dL, p = 0.001)(DHb24 ABRD = 3.33 mg/dL and DHb24 C = 3.1mg/dL, respectively). The administration of a single tranexamic acid dose of 15 mg/kg one hour before incision is more effective than reinfusion drains in reducing postoperative allogeneic blood use in patients who underwent primary hip arthroplasty. Keywords: tranexamic acid, arthroplasty, hip, autotransfusion, efficacy study

Issue: 2016, Volume 67, Issue 11

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