Impact of Tranexamic Acid on Perioperative Blood Loss and Transfusion Requirements in Orthopedic Trauma Surgery

Abstract

Background: Orthopedic trauma surgeries often involve significant blood loss, leading to increased transfusion requirements and associated complications. Tranexamic acid (TXA), an antifibrinolytic agent, has been shown to reduce blood loss in various surgical settings. This study aims to evaluate the impact of TXA on perioperative blood loss and transfusion requirements in orthopedic trauma surgery. Methods: A cross-sectional study was conducted at North East Medical College and Hospital (NEMCH), Sylhet, from October 2023 to October 2024, involving 96 patients undergoing orthopedic trauma surgery. The patients were divided into two groups: the TXA group (n=48) received 1g of TXA intravenously 30 minutes before surgery and 1g postoperatively, while the control group (n=48) did not receive TXA. Perioperative blood loss, transfusion requirements, thromboembolic events, and surgical outcomes were compared between the two groups. Results: The TXA group showed a significant reduction in intraoperative blood loss (220 ± 45 mL vs. 340 ± 55 mL, p<0.01) and postoperative blood loss (150 ± 35 mL vs. 280 ± 50 mL, p<0.01) compared to the control group. The TXA group also had fewer patients requiring blood transfusions (18.7% vs. 37.5%, p=0.02) and a lower mean number of units transfused (0.6 ± 0.4 vs. 1.3 ± 0.5, p<0.01). There was no significant difference in thromboembolic events between the groups (p=0.51). The duration of surgery and hospital stay were similar between the groups, although the TXA group had a shorter hospital stay (5.2 ± 1.1 days vs. 6.5 ± 1.4 days, p<0.01). Conclusion: TXA significantly reduced both perioperative blood loss and transfusion requirements in orthopedic trauma surgery, with no increase in thromboembolic events. These findings support the routine use of TXA in orthopedic trauma surgeries to enhance patient outcomes and reduce complications. Further large-scale, multicenter studies are recommended to confirm these results.