Department of Orthopaedic Surgery, Ochsner Medical Center, New Orleans, Louisiana.
J Arthroplasty. 2013 Sep;28(8 Suppl):74-7. doi: 10.1016/j.arth.2013.06.037.
The purpose of this study was to evaluate the effectiveness of topical tranexamic acid in primary TKA from a clinical and economic standpoint. We retrospectively reviewed 683 primary total knee arthroplasties performed at a single institution over a 2-year period. We compared 373 cases performed in 2010 without tranexamic acid to 310 cases performed in 2011 with tranexamic acid. Demographic data, hemoglobin levels, transfusion rates, hospital length of stay, cost, and perioperative complications during the first 3 months were collected. Statistical analysis was performed using two sample t-tests and Fisher's exact tests. There was no difference in age, sex, height, or pre-operative hemoglobin between the two groups. The tranexamic acid group had significantly higher post-operative hemoglobin (P<0.0001), lower transfusion rate (P<0.0001), decreased length of stay (P<0.0001), decreased blood bank costs (P<0.0001), increased pharmacy cost (P<0.0001), and decreased total direct cost to the hospital (P<0.0001). The average savings was approximately $1500 per patient. There were no differences in thromboembolic events or infection. The use topical tranexamic acid in primary TKA is safe, effective, and results in significant cost savings.
本研究旨在从临床和经济角度评估局部使用氨甲环酸在初次全膝关节置换术中的效果。我们回顾性分析了在单家机构 2 年内进行的 683 例初次全膝关节置换术。我们将 2010 年未使用氨甲环酸的 373 例与 2011 年使用氨甲环酸的 310 例进行比较。收集了人口统计学数据、血红蛋白水平、输血率、住院时间、成本和术后 3 个月内的围手术期并发症。使用双样本 t 检验和 Fisher 确切检验进行统计分析。两组间年龄、性别、身高或术前血红蛋白无差异。氨甲环酸组术后血红蛋白显著升高（P<0.0001），输血率降低（P<0.0001），住院时间缩短（P<0.0001），血库成本降低（P<0.0001），药房成本增加（P<0.0001），医院总直接成本降低（P<0.0001）。平均节省约 1500 美元/例。血栓栓塞事件或感染无差异。在初次全膝关节置换术中局部使用氨甲环酸是安全、有效且可显著节省成本。
