441 Intravenous Tranexamic Acid Given at Femoral Fragility Fracture Surgery Reduces Blood Transfusion Requirements Four-Fold

Abstract Introduction Tranexamic acid (TXA) is proven to reduce blood loss in several surgical fields, but its use femoral fragility fracture (FFF) management ill defined. This study examined the effect of intraoperative TXA on rate postoperative transfusion following FFF. Method A prospective non-randomized case-control 361 consecutive patients admitted centre with FFFs over a 4-month period was performed. Intravenous 1g administered intraoperatively at discretion operating team: 178 received and 183 did not. Results Patients given required fewer transfusions: 15/178 (8.4%) vs controls 58/183 (31.7%), (p < 0.001). Calculated (mean difference -222ml (-337 -106, 95%CI), p 0.001) percentage drop Hb -4.3% (-6.3 -2.3, were significantly lower group. The CBL greatest intramedullary nail (n = 49: mean -394ml, 0.030) DHS 101, -216ml, 0.032). There no significant complication rates: venous thromboembolism 2/178 control 1/182 0.620); MI/stroke/TIA 0/182 0.244) Conclusions Intraoperative intravenous reduced calculated requirements surgery without increasing complications.