Effect of Tranexamic Acid on Transfusion and Blood Loss in Acetabular Fracture Surgery: A Randomized Clinical Trial

Background: Acetabular fracture surgery may be associated with complications such as blood loss during and after surgery, which can lead to increased morbidity and mortality. Tranexamic acid (TXA) reduces bleeding by reducing local fibrinolysis. This study aimed to evaluate the efficacy of TXA in reducing transfusion and blood loss in acetabular fracture surgery. Methods: Overall ۵۱ patients were randomly divided into two groups TXA and control. Preoperative and postoperative hemoglobin, intraoperative and postoperative bleeding volume, as well as deep vein thrombosis (DVT) symptoms, were recorded in both groups. Results: Out of ۵۱ patients, ۴۱ (۸۰.۴%) were male, and ۱۰ (۱۹.۶%) were female. Bleeding volume during surgery was ۳۸۶.۵۳±۷۶.۸۸ in the TXA group and ۸۵۴.۰۰±۳۶۹.۹۴ in the control group, indicating a significant difference (P<۰.۰۰۱). Also, ۲۱ patients underwent packed cell transfusion, of whom۱۹ were in the control group and two in the TXA group (P<۰.۰۰۱). The mean duration of surgery was ۱۲۵.۳۸±۱۴.۴۱ minutes in the TXA group and ۱۵۶.۴۰±۱۶.۷۴ minutes in the control group (P <۰.۰۰۱). Postoperative bleeding volume was reported as ۱۰۵.۷۶± ۵۱.۶۲ in the TXA group and ۲۳۰.۰۰± ۴۷.۸۷ in the control group (P<۰.۰۰۱). Furthermore, TXA did not increase the incidence of DVT. Conclusion: Intravenous injection of TXA in acetabular fractures significantly reduced the need for blood transfusions, blood loss, and duration of surgery. Meanwhile, it did not increase the risk of DVT.

Keywords:

Acetabular Fracture , Tranexamic acid , transfusion