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Chemical Thromboprophylaxis Is Not Necessary to Reduce Risk of Thromboembolism With Tranexamic Acid After Total Hip Arthroplasty

Title
Chemical Thromboprophylaxis Is Not Necessary to Reduce Risk of Thromboembolism With Tranexamic Acid After Total Hip Arthroplasty
Authors
Kim, Young-HooPark, Jang-WonKim, Jun-Shik
Ewha Authors
김영후김준식박장원
SCOPUS Author ID
김영후scopus; 김준식scopus; 박장원scopus
Issue Date
2017
Journal Title
JOURNAL OF ARTHROPLASTY
ISSN
0883-5403JCR Link1532-8406JCR Link
Citation
vol. 32, no. 2, pp. 641 - 644
Keywords
chemical thromboprophylaxisriskthromboembolismtranexamic acidtotal hip arthroplasty
Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Background: The major concern with the use of tranexamic acid is that it may promote a hypercoagulable state and increase the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE), particularly when chemical thromboprophylaxis is not used. The objective of this study was to ascertain whether tranexamic acid reduces blood loss and transfusion amounts and increases the prevalence of DVT and PE in the patients undergoing primary cementless total hip arthroplasty (THA) without the use of routine chemical thromboprophylaxis. Methods: There were 480 patients (582 hips) in the control group who did not receive tranexamic acid and 487 patients (584 hips) in the study group who received tranexamic acid. Mechanical compression device was applied without any chemical thromboprophylaxis. Transfusion rates and volumes were recorded. DVT was diagnosed using both sonogram and venogram at 7 or 8 days postoperatively. All patients had pre- and postoperative perfusion lung scanning to defect pulmonary embolism (PE). Results: Intraoperative (614 vs 389 mL) and postoperative blood loss (515 vs 329 mL) and transfusion volumes (3 units vs 1.5 units) were significantly lower (P < .001) in the tranexamic acid group. The prevalence of DVT was 15% (87 of 582 hips) in the control group and 18% (105 of 584 hips) in the tranexamic acid group. No fatal PE occurred in either group. Conclusion: The use of tranexamic acid reduces the volume of blood transfusion and does not increase the prevalence of DVT or PE in the patients who did not receive routine chemical thromboprophylaxis after primary cementless THA. (C) 2016 Elsevier Inc. All rights reserved.
DOI
10.1016/j.arth.2016.07.048
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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