does a single bolus dose of tranexamic acid reduce blood loss and transfusion requirements during hip fracture surgery? a prospective randomezed double blind study in 67 patients

extensive blood loss in total hip surgery is well known and is associated with a high transfusion rate of allogeneic blood. the aim of this study is to assess the effects of intraoperative tranexamic acid on post-operative bleeding and need for allogeneic transfusion during hip fracture surgery. we investigated 67 patients undergoing hip fracture surgery in a prospective, randomized, double-blinded study. 32 patients received tranexamic acid (ta) given in a bolus dose of 15 mg/kg before surgical incision. the remaining, 35 patients were allocated as control group. postoperative bleeding, transfusions, complications, and hospital stay were recorded. the intraoperative bleeding was significantly lower in the ta group (652 ± 228 ml vs. 1108 ± 372 ml, p <0.003). post operative drainage was lower in ta group (296 ± 85 ml vs. 375 ± 110 ml, p <0.195). there were no differences in coagulation parameters. the rates of transfused patients in ta and control groups were 37 % and 57 %. in ta group, hospital stay was 4.3 ± 1.6 days (vs. 5.8 ± 1.5 days in control group; p< 0.05). there is one in hospital mortality in control group. we conclude that tranexamic acid significantly reduces blood loss during hip fracture surgery.