Effect of tranexamic acid on blood loss in total hip arthroplasty at Muhimbili Orthopaedic Institute: a retrospective comparative study

Abstract

Background: Total Hip Arthroplasty (THA) is associated with significant intraoperative and postoperative blood loss. At present, six to eight cases of THA are being performed weekly at MOI. Tranexamic acid (TXA) comes as a saver in the sense that when administered preoperatively reduces bleeding and the necessary number of transfusions among patients undergoing THA. This study is, therefore, aimed at comparing the use of Tranexamic acid in reducing the need for post THA blood transfusion to those who receive it and to those who do not receive it. Our null hypothesis is that there is no difference in postoperative blood transfusion for post Total Hip Arthroplasty among TXA receiving and non-TXA receiving group. Methods: The study design is a hospital-based retrospective comparative study, 204 patients met our study inclusion criteria. The patients were divided into two groups, the first group were those patients who received TXA preoperatively and the second groups were those patients who didn't receive TXA. The number of patients who got blood transfusions in both groups was determined. Abstraction form was used to collect information from the patient's files. The results were analyzed by Statistical Package for the Social Sciences (SPSS) computer program version 20. Results: The study showed that among the participants who underwent THA and required postoperative blood transfusion the majority (74.4%) were those who did not receive TXA, as compared to those who received TXA with (60.3%). This was statistically significant with a p-value of 0.033. Also, significant results were observed with Odd ratio of 0.515 in which Tranexamic acid showed to influence the reduction of blood transfusion. Conclusion: Pre-operative Tranexamic Acid administration to patients who underwent Total Arthroplasty showed to be effective in significantly reducing the need for postoperative blood transfusion.