Efficacy and safety of tranexamic acid in orthopaedic trauma surgery: a meta-analysis

M. Hu, Z.-B. Liu, G. Bi

Department of Orthopaedics, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China. bigang501@163.com

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• Pharmacology

OBJECTIVE: To systematically review the efficacy and safety of tranexamic acid (TXA) in reducing blood transfusion and total blood loss in patients undergoing orthopaedic trauma surgery.

MATERIALS AND METHODS: A systematic literature search was performed using PubMed, Embase and Cochrane Library databases. The search time was incepted to February 2019. Two reviewers independently screened literature, extracted data, and assessed risk of bias. Then, meta-analysis was performed using RevMan 5.3.

RESULTS: A total of 10 studies were included, with 936 patients. The pooled results indicated that TXA group was superior to control group in the total blood loss [MD=-157.61, 95%CI (-250.09, -65.13), p=0.0008], blood transfusion [OR=0.59, 95%CI (0.43, 0.81), p=0.001], and the wound complications [OR=0.59, 95%CI (0.43, 0.81), p=0.001]. There was no significant difference in risk of thromboembolic events [OR=1.27, 95%CI (0.78, 2.12), p=0.35] and the mortality [OR=0.79, 95%CI (0.35, 1.78), p=0.57] between TXA and control group.

CONCLUSIONS: TXA could effectively reduce blood transfusion, total blood loss, and wound complications in patients undergoing orthopedic trauma surgery. Furthermore, TXA does not significantly increase the incidence of thromboembolic events and mortality. Due to the limited quality of the included studies, more high-quality works are required to verify the above conclusions.

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