Intravenous Tranexamic Acid Reduces Total Blood Loss in Reverse Total Shoulder arthroplasty: a Prospective, Double-Blinded, Randomized, Controlled Trial.

Document Type

Article

Publication Date

8-1-2017

Abstract

BACKGROUND: Patients undergoing reverse total shoulder arthroplasty (RTSA) are at risk of significant perioperative blood loss. To date, few studies have examined the effectiveness of tranexamic acid (TXA) to reduce blood loss in the setting of RTSA.

METHODS: In a prospective, double-blinded, single-surgeon trial, we analyzed 102 patients undergoing primary RTSA who were randomized to receive intravenous TXA (n = 53) or placebo (n = 49). Calculated total blood loss, drain output, and hemoglobin (Hb) drop were measured. Postoperative transfusions were recorded. Complications were assessed out to 6 weeks postoperatively.

RESULTS: Total blood loss was less for the TXA group (1122.4  ± 411.6 mL) than the placebo group (1472.6 ± 475.4 mL, P < .001). Total drain output was less for the TXA group (221.4 ± 126.2 mL) than the placebo group (371.9 ± 166.3 mL , P < .001). Total Hb loss was less in the TXA group (154.57 ± 60.29 g) compared with the placebo group (200.1 ± 65.5 g, P = .001). Transfusion rates differed significantly at postoperative day 1; however, overall transfusion rates did not vary significantly. Seven patients (14.3%) and 12 units were transfused in the placebo group compared with 3 patients (5.7%) and 3 units in the TXA group.

DISCUSSION: In this cohort of patients undergoing primary RTSA, TXA was effective in reducing total drain output, total Hb loss, and total blood loss compared with a placebo control.

Volume

26

Issue

8

First Page

1383

Comments

Annual Meeting of the American Shoulder and Elbow Surgeons New Orleans, LA, October 11-14, 2017.

Last Page

1389

ISSN

1532-6500

PubMed ID

28162887

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