Fracture of Femur Clinical Trial
Official title:
The Use of Tranexamic Acid in Chinese Elderly Patients Undergoing Femoral Nailing for Intertrochanteric Fracture: A Randomized Controlled Trial
Hip fracture posed a major challenge to the health care system, with the one-year mortality
of hip fracture reported as being approximately 20%. Perioperative haemoglobin level was
associated with functional level of the patient and even mortality.
Different methods for administration of tranexamic acid had been described. It was well
established that systemic administration of tranexamic acid could reduce perioperative blood
loss and transfusion rate. Topical administration had been shown to decrease blood loss and
transfusion rate.
The objective of our study is to investigate the hypothesis that tranexamic acid will reduce
blood loss and transfusion rate in elderly patients undergoing hip fracture surgery.
The incidence of geriatric hip fractures is projected to increase by more than 250% in the
next twenty-five years as the world population ages. Hip fracture in elderly patients are
associated with significant morbidity and mortality. One of the significant morbidity is
blood loss, which has been reported as high as 1500ml. Blood loss may lead subsequent blood
transfusion. The rate of blood transfusion has been reported between 20 to 60%. Blood loss
and subsequent blood transfusion could lengthen the overall hospital length of stay and delay
the rehabilitation.
Tranexamic acid, one of antifibrinolytic agents, is a synthetic derivative of the amino acid
lysine and acts as a competitive inhibitor in the activation of plasminogen to plasmin,
therefore preventing the degradation of fibrin. Shakur et al. reported that the use could
reduce mortality in trauma patients. Tranexamic acid has been widely used in elective
orthopaedic surgery such as total joint replacement and spine surgery. Several authors
reported that tranexamic acid could decreases the blood loss, transfusion rate and cost.
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