Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials

Yıl: 2020 Cilt: 54 Sayı: 1 Sayfa Aralığı: 4 - 24 Metin Dili: İngilizce DOI: doi:10.5152/j.aott.2020.01.88 İndeks Tarihi: 20-11-2020

Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials

Öz:
Objective: The aim of this study was to evaluate the efficacy and safety of tranexamic acid (TXA) in elderly patients with intertrochanteric fracture undergoing intramedullary fixation surgery. Methods: We searched MEDLINE, the Cochrane Library and EMBASE for published randomized clinical trials relevant to use of TXA in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery. Meta-analysis was performed according to the guidelines of the Cochrane Reviewer’s Hand book. Results: Five trials assessing 540 patients were included for meta-analysis. The pooled results showed that the mean total blood loss in TXA group was significant lower than that in the control group (mean difference - 172.83, 95% CI -241.43 to -104.23; p<0.00001, f ixed-effect model). The intra- and postoperative transfusion rate for the TXA group was 34.4% (91/264) and for the control group was 49.27% (136/276), and the relative risk was 0.71 (95% CI 0.52 to 0.97; p<0.03, random-effect model) with substantial heterogeneity (I2=63%, p=0.03). The overall incidence of thrombotic events was 6.43% (17/264) in the intravenous TXA group, 7.63% (21/275) in the control group, with no significant difference (relative risk 0.84, 95% CI 0.46 to 1.54; p=0.57, fixed-effect model). Conclusion: The present evidence shows that TXA can significantly reduce total and hidden blood loss, transfusion rate, and do not increase the risk of thrombotic events in elderly patients with intertrochanteric fracture undergoing intramedullary fixation surgery. However, the impact of TXA on thrombotic events needs to be researched in more high-quality, large-sample randomized clinical trials.
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APA Luo X, Tang X, Huang H (2020). Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. , 4 - 24. doi:10.5152/j.aott.2020.01.88
Chicago Luo Xiangping,Tang Xiong,Huang Hangqing Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. (2020): 4 - 24. doi:10.5152/j.aott.2020.01.88
MLA Luo Xiangping,Tang Xiong,Huang Hangqing Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. , 2020, ss.4 - 24. doi:10.5152/j.aott.2020.01.88
AMA Luo X,Tang X,Huang H Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. . 2020; 4 - 24. doi:10.5152/j.aott.2020.01.88
Vancouver Luo X,Tang X,Huang H Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. . 2020; 4 - 24. doi:10.5152/j.aott.2020.01.88
IEEE Luo X,Tang X,Huang H "Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials." , ss.4 - 24, 2020. doi:10.5152/j.aott.2020.01.88
ISNAD Luo, Xiangping vd. "Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials". (2020), 4-24. https://doi.org/doi:10.5152/j.aott.2020.01.88
APA Luo X, Tang X, Huang H (2020). Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica, 54(1), 4 - 24. doi:10.5152/j.aott.2020.01.88
Chicago Luo Xiangping,Tang Xiong,Huang Hangqing Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica 54, no.1 (2020): 4 - 24. doi:10.5152/j.aott.2020.01.88
MLA Luo Xiangping,Tang Xiong,Huang Hangqing Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica, vol.54, no.1, 2020, ss.4 - 24. doi:10.5152/j.aott.2020.01.88
AMA Luo X,Tang X,Huang H Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica. 2020; 54(1): 4 - 24. doi:10.5152/j.aott.2020.01.88
Vancouver Luo X,Tang X,Huang H Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica. 2020; 54(1): 4 - 24. doi:10.5152/j.aott.2020.01.88
IEEE Luo X,Tang X,Huang H "Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials." Acta Orthopaedica et Traumatologica Turcica, 54, ss.4 - 24, 2020. doi:10.5152/j.aott.2020.01.88
ISNAD Luo, Xiangping vd. "Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials". Acta Orthopaedica et Traumatologica Turcica 54/1 (2020), 4-24. https://doi.org/doi:10.5152/j.aott.2020.01.88