Gausden EB, et al. - This study focused on the benefits of tranexamic acid (TXA) use in orthopaedic trauma surgery, in terms of blood transfusion risk, blood loss, and risk of thromboembolic events. The evidence demonstrated that TXA attenuates risk of blood transfusion and perioperative blood loss in patients with orthopaedic trauma, without markedly impacting the risk of symptomatic thromboembolic events.

Methods

• Researchers performed a systematic literature search using MEDLINE, Embase, ClinicalTrials.gov, and conference proceeding abstracts from 2014 to 2016.
• A minimum of 2 reviewers screened each study and graded quality.
• The risk of receiving a blood transfusion in the TXA group versus control was the primary outcome measure.
• They carried out a meta-analysis to construct a combined odds ratio (OR) of receiving a blood transfusion, mean difference (MD) of blood loss, and OR of thromboembolic events.

Results

• The quantitative analysis (1,333 patients) included a total of 12 studies.
• Patients who were administered TXA versus controls had significantly less risk of blood transfusion [OR 0.407; 95% confidence interval (CI) 0.278–0.594, I² = 34, Q = 17, P ≤ 0.001].
• Researchers also observed that there was significantly less blood loss in the TXA group compared with controls, as the mean difference was 304 mL (95% CI, 142–467 mL) (I²= 94, Q value = 103, P < 0.001).
• In addition, they reported no significant difference in risk of symptomatic thromboembolic events (OR 0.968; 95% CI, 0.530–1.766, I² = 0, Q value = 5, P = 0.684).