Hemodynamics, fluids & transfusion
The safety of tranexamic acid administration in total knee arthroplasty: a population‐based study from Taiwan
Main finding · Blood transfusionResult — go to the resultRelative risk 0.50 95% CI 0.48–0.51Authors' conclusion
In conclusion, tranexamic acid use was associated with decreased blood transfusion and was not associated with thromboembolic events.
Study context
- Population
- Patients undergoing unilateral total knee arthroplasty, Taiwan national health insurance database, 2010–2019
- Participants
- 226,719 knee arthroplasty cases
- Exposure
- TXA vs no TXA in unilateral total knee arthroplasty
- TXAn = 97,237
- Outcome
- Safety (adverse events) and peri-operative blood transfusion
- Follow-up
- 60 days
Methodological detailspopulation-based, national health insurance database, propensity-score matched, logistic regression
- Population-based
- National health insurance database
- Propensity-score matched
- Logistic regression
Main finding
Blood transfusion
Relative risk
0.50
95% CI 0.48–0.51
TXA vs No TXA
RR 0.50 (95% CI 0.48–0.51)
As reported in the abstract
- Overall transfusion rate
- 38.9% (88,258)
Observational data: associations, not effects.
Further findings
Thromboembolic events and mortality (PE, DVT, arterial/venous thromboembolism, acute MI, ischaemic stroke, in-hospital mortality)
- TXA not associated with any of these events
- After propensity-score matching
Safety
AKI
- Absolute risk of kidney injury in patients with existing CKD, irrespective of TXA
- 832 (per 10,000; 95% CI 797-869)
- TXA significantly associated with AKI
- After propensity-score matching
Surgical site infection
- TXA associated with surgical site infection
- Strong interaction between blood transfusion, TXA and surgical site infection
Original publication
The safety of tranexamic acid administration in total knee arthroplasty: a population‐based study from Taiwan. Anaesthesia. Published 17 November 2022. doi:10.
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