Transfusions and cost-benefit of oral versus intravenous tranexamic acid in primary total hip arthroplasty: A meta-analysis of randomized controlled trials
| Autor: | Ning Wang, Xiaojiang Xiong, Hongxia Chen, Yong Yang, Lixin Xu, Wangwei Liu, Ming Ji, Jin Tang, Tao Yang |
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| Rok vydání: | 2019 |
| Předmět: |
total hip arthroplasty
medicine.medical_treatment Arthroplasty Replacement Hip Cost-Benefit Analysis Blood Loss Surgical Administration Oral Cochrane Library tranexamic acid law.invention 03 medical and health sciences Hemoglobins oral 0302 clinical medicine Randomized controlled trial law Medicine Humans Blood Transfusion 030212 general & internal medicine Randomized Controlled Trials as Topic Venous Thrombosis business.industry Incidence (epidemiology) General Medicine medicine.disease Arthroplasty Antifibrinolytic Agents Pulmonary embolism Venous thrombosis 030220 oncology & carcinogenesis Anesthesia Meta-analysis intravenous Administration Intravenous business Tranexamic acid Systematic Review and Meta-Analysis medicine.drug Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Background: The purpose of this study was to assess the cost benefit and transfusions of oral and IV tranexamic acid (TXA) in primary total hip arthroplasty (THA). Methods: PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials (RCTs) comparing oral and IV TXA in primary THA. Primary outcomes were total blood loss, maximum hemoglobin drop, transfusion requirements, and cost benefit. Secondary outcomes were length of stay, deep venous thrombosis (DVT) and/or pulmonary embolism (PE). Results: Four independent RCTs were included involving 391 patients. There was no difference in the total blood loss (P = .99), maximum hemoglobin drop (P = .73), and the length of stay (P = .95) between the 2 groups. Transfusion requirements (P = .97) were similar. The total mean cost was the US $75.41 in oral TXA group and the US $580.83 in IV TXA group. The incidence of DVT (P = .3) did not differ significantly between the 2 groups, and no PE was reported in all studies. Conclusion: Oral TXA shows similar efficacy and safety as IV TXA in reducing total blood loss, maximum hemoglobin drop and transfusion requirements in primary THA. However, oral TXA may be more cost-benefit than IV TXA. Level of Evidence: Level I, therapeutic study. |
| Databáze: | OpenAIRE |
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