Cost benefit analysis of the use of tranexamic acid in primary lower limb arthroplasty: A retrospective cohort study

作     者：Niall P McGoldrick Eabhann M O'Connor Nikos Davarinos Rose Galvin John F Quinlan 

作者机构：Department of Trauma and Orthopaedic SurgeryTallaght Hospital Department of Clinical TherapiesUniversity of Limerick 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2015年第6卷第11期

页      面：977-982页

学科分类：0403[教育学-体育学] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Arthroplasty Hip Knee Tranexamic acid Cost-benefit analysis 

摘      要：AIM: To examine the cost benefit conferred by the perioperative administration of intravenous tranexamic acid(TXA) in lower limb ***: This study evaluates the use of TXA in 200 consecutive lower limb arthroplasties performed in a single surgeon series. The initial 100 patients(control group) underwent surgery without perioperative administration of TXA while the subsequent 100 patients(TXA group) all received 1 g TXA at the time of induction of anaesthesia. Pre- and post-operative haemoglobin, platelet count, haematocrit, the use of blood product post-operatively, length of stay were examined. A financial analysis of both groups was then undertaken. RESULTS: The mean age of patients in both groups was 63 ± 13 years. There were no significant differences between groups in terms of gender(P = 0.47), proportion of total hip replacement to total knee replacement(P = 0.25) or pre-operative haemoglobin(P = 0.43). In the control group, the transfusion rate was 22%. In the TXA group, the transfusion rate dropped to 2%(P 0.001). The mean post-operative haemoglobin was 10.82 ± 1.55g/dL in the control group vs 11.33 ± 1.27 g/dL in the TXA group(P = 0.01). The total cost of transfused blood products was €11055 and €603 respectively. The mean length of stay in the control group was 6.53 ± 5.93 d vs 5.47 ± 4.26 d in the TXA group(P = 0.15) leading to an estimated financial saving of €114586. There was one pulmonary embolus in the control group and one deep venous thrombosis in the TXA ***: Intravenous TXA reduces blood loss in lower limb arthroplasty. This leads to lower transfusion rates, shorter length of stay in hospital and significant financial savings.