Low Risk of Thromboembolic Events After Routine Administration of Tranexamic Acid in Hip and Knee Arthroplasty

Abstract Background The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences and predictors of TE events after routine administration of IV TXA in THA and TKA. Methods 3,159 THA or TKA procedures performed from 2007-2013 at our institution were included. IV TXA, 1 g, was administered preoperatively if not contraindicated. Relevant patient characteristics and comorbidity information were extracted locally from the database. Data on TE events occurring within 90 days postoperatively came from The Danish National Patient Registry . Patient characteristics, comorbidities and TE events were compared between TXA groups. A logistic regression model was used to evaluate predictors of TE events. Results Of 3,159 procedures, 2,766 (=87.6%) received TXA (TXA+ group) preoperatively, while 393 (=12.4%) did not (TXA- group). Mean age, distributions of gender, ASA score, anesthesia method, duration of surgery, diagnosis and survival status were all statistically significant different (p-values