Abstract:Objective: To evaluate the efficacy and safety of early tranexamic acid (TXA) intervention in reducing hidden blood loss (HBL) after osteoporotic distal femoral fracture. Methods: Retrospective analysis was performed. Elderly patients with osteoporotic distal femoral fracture (≥65 years old) admitted to our hospital from October 2018 to October 2020 were collected as the research subjects, and they were divided into TXA group (October 2018 to October 2019) and NS group (October 2019 to October 2020) according to the time of admission. TXA group was given 2 g of TXA intravenous infusion immediately after admission, and NS group was given the same amount of NS intravenous infusion immediately after admission. The general data, changes of hemoglobin (HGB), hematocrit (HCT) and HBL 1-3 days after trauma, the rate of blood transfusion and the incidence of deep vein thrombosis/pulmonary embolism were analyzed and compared between the two groups. Results: A total of 87 patients were included, including 45 cases in TXA group and 42 cases in NS group. There were no statistically significant differences in general data between the two groups (P>0.05). The levels of HGB and HCT in TXA group and NS group 1-3 days after trauma decreased with the time extension after admission (P<0.05). The level of HGB in TXA group was higher than that in NS group 2 and 3 days after injury (P<0.05), and the level of HCT in TXA group was lower than that in NS group 1-3 days after injury (P<0.05). HBL in TXA group and NS group increased with time prolongation 1-3 days after injury (P<0.05). HBL in TXA group was lower than that in NS group 1-3 days after injury (P<0.05). There were statistically significant differences in the rate of blood transfusion after injury between the two groups (P<0.05), and there was no statistically significant difference in the incidence of venous thrombosis in lower extremity between the two groups (P>0.05). Conclusion: In elderly patients with osteoporotic distal femoral fracture, hidden blood loss can’t be ignored after injury. Early post-injury (≤6 h) TXA intervention can effectively reduce the amount of hidden blood loss and blood transfusion rate, and does not increase the incidence of deep vein thrombosis, which is safe and feasible.
