European Journal of Cardiovascular Medicine

Background:  To evaluate the efficacy and safety of the Tranexamic acid in hip fracture surgery patients. Method: Consecutive hip fracture 50 patients eligible for the study were randomised to TXA and Placebo group. TXA group received 1 gram of tranexamic acid in 100 ml NSIV and placebo group received 100 ml NS IV, given 10minutes before incision and same dose is repeated just before the skin closure. Primary outcome measures were: Total perioperative calculated blood loss, fall in haemoglobin at postoperative day two, blood transfusion rate, total drain output. Secondary outcome measures were: Analysis of Thromboembolic complications within 4 weeks after surgery. Results: Twenty-five patients each in TXA group and Placebo group are included in the study. Total perioperative blood loss was significantly lower in the TXA group than in the Placebo group (374±78.2 mL vs. 601.2±125.3 ml;P < 0.030). Postoperative PRBC transfusion rate was significantly lower in the TXA group than in the Placebo group (4/25,16 % vs. 10/25,40 %;P=0.025). Patients who received TXA had lesser fall in haemoglobin on Postoperative day 2 (0.5±0.8 vs. 2.1±2.7; P= 0.031) than the control group and this was statistically significant. Mean volume of blood in the drain was 35.43 ml as compared to 95.24 ml in placebo group showing a highly significant reduction in postoperative blood loss(P=0.02). None of the patients in both the groups were found to have any thromboembolic events after surgery. Conclusion: The present randomised study demonstrated that the administration of TXA reduces the total Perioperative blood loss, postoperative anaemia and need for transfusion in patients undergoing surgeries for hip and has no significant effect on the risk of symptomatic thromboembolic events. However further research is necessary to determine effectiveness, safety and usage of Tranexamic acid in high-risk patients.