Safety of Tranexamic Acid in Hip and Knee Arthroplasty in Hi
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With the increasing use of tranexamic acid in total hip and knee arthroplasties, safety concerns remain. The study did not show an increased risk for complications.

Among 765,011 total hip/knee arthroplasties, tranexamic acid use was assessed in three high-risk groups: group I with patients with a history of venous thromboembolism, myocardial infarction, seizures, or ischemic stroke/transient ischemic attack (n = 27,890); group II with renal disease (n = 44,608); and group III with atrial fibrillation (n = 45,952).

The coprimary outcomes were blood transfusion and new-onset “composite complications” (venous thromboembolism, myocardial infarction, seizures, and ischemic stroke/transient ischemic attack). Associations between tranexamic acid use and outcomes were measured separately by the high-risk group.

Overall, 404,974 patients received tranexamic acid, with similar frequencies across high-risk groups I.

--Tranexamic acid use was associated with decreased odds of blood transfusion in high-risk groups I, group II, and group III; all adjusted comparisons P < 0.001.

--No increased odds of composite complications were observed in high-risk group I, group II, and group III; all adjusted comparisons P > 0.999.

Although effective in reducing blood transfusions, tranexamic acid is not associated with increased complications, irrespective of the patient's high-risk status at baseline.

Anesthesiology
Source: https://doi.org/10.1097/ALN.0000000000003772
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