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- Talk
- 22/09/2021
- UK
Peri-Operative Administration of Tranexamic Acid in Lower Limb Arthroplasty: A Multicentre, Prospective Cohort Study
Description
In this presentation led by Tom Lloyd, an orthopedic registrar at the Thames Valley Deanery, the focus is on a national collaborative study investigating the use of tranexamic acid (TXA) in patients undergoing hip and knee replacements in the UK. Lloyd highlights the significant blood loss associated with these surgeries, leading to substantial rates of allogeneic blood transfusions, which elevate the risk of perioperative complications such as cardiovascular morbidity, surgical site infections, and even mortality. He points out that historically, orthopedic procedures account for about 10% of blood red cell usage in the UK, and the costs along with demand for blood products underpin the need for effective patient blood management strategies.
The study aims to evaluate current practices regarding TXA administration, noting that while there is a strong consensus on the benefits of TXA, there remains ambiguity over the optimal administration protocols. The researchers performed a multicenter prospective cohort study across 56 UK NHS hospitals, including 1,714 patient episodes, with the aim of providing insights into the effectiveness of TXA in managing blood loss. The results showed good compliance with NICE guidelines, where 89.5% of patients received TXA, predominantly as a single intravenous dose during preoperative or intraoperative phases.
Lloyd emphasizes the observation that one-third of patients were anemic preoperatively and a striking 81.7% postoperatively, indicating a critical need for improved screening and management strategies for preoperative anemia. The study concludes with a low overall transfusion rate of 3.1%, which increases to 6.5% among anemic patients, marking an encouraging trend in evolving transfusion practices within the UK. The presentation wraps up with acknowledgments to collaborators and emphasizes the significance of refining current practices to enhance patient outcomes in orthopedic surgeries.