氨甲环酸在髋部骨折手术中的应用、有效性及安全性：一项基于人群的研究。
Utilization, effectiveness, and safety of tranexamic acid use in hip fracture surgery: A population-based study.
作者信息
Cheung Zoe B, Anthony Shawn G, Forsh David A, Podolnick Jeremy, Zubizarreta Nicole, Galatz Leesa M, Poeran Jashvant
机构信息
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NY, USA.
Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai Health System, New York, NY, USA.
出版信息
J Orthop. 2020 Jan 28;20:167-172. doi: 10.1016/j.jor.2020.01.040. eCollection 2020 Jul-Aug.
Abstract
OBJECTIVE
To assess the effect of tranexamic acid (TXA) use in hip fracture surgery.
METHODS
A retrospective cohort study was performed using the Premier Healthcare database. A propensity score matching approach was applied to assess associations between TXA use and blood transfusion, perioperative complications, length of stay (LOS), and hospitalization cost.
RESULTS
In 153,169 patients, TXA use was associated with a 17% decrease in odds of blood transfusion, no increase in the risk of perioperative complications, 16% shorter LOS, and minimal effects on hospitalization cost.
CONCLUSION
Our results are in support of a wider use of TXA in hip fracture surgery.
LEVEL OF EVIDENCE
Level III.
摘要
目的
评估氨甲环酸（TXA）在髋部骨折手术中的应用效果。
方法
利用Premier医疗数据库进行一项回顾性队列研究。采用倾向评分匹配法评估TXA使用与输血、围手术期并发症、住院时间（LOS）和住院费用之间的关联。
结果
在153169例患者中，使用TXA与输血几率降低17%、围手术期并发症风险未增加、住院时间缩短16%以及对住院费用影响极小相关。
结论
我们的结果支持在髋部骨折手术中更广泛地使用TXA。
证据级别
三级。
相似文献
1
Utilization, effectiveness, and safety of tranexamic acid use in hip fracture surgery: A population-based study.氨甲环酸在髋部骨折手术中的应用、有效性及安全性：一项基于人群的研究。
J Orthop. 2020 Jan 28;20:167-172. doi: 10.1016/j.jor.2020.01.040. eCollection 2020 Jul-Aug.
2
Efficacy and safety of tranexamic acid in geriatric hip fracture with hemiarthroplasty: a retrospective cohort study.氨甲环酸治疗老年人工髋关节半髋关节置换术后疗效及安全性的回顾性队列研究。
BMC Musculoskelet Disord. 2019 Jun 28;20(1):304. doi: 10.1186/s12891-019-2670-5.
3
Utilization and Real-world Effectiveness of Tranexamic Use in Shoulder Arthroplasty: A Population-based Study.肩关节炎置换术中氨甲环酸的应用及真实世界疗效：一项基于人群的研究。
J Am Acad Orthop Surg. 2019 Oct 1;27(19):736-742. doi: 10.5435/JAAOS-D-18-00206.
4
Relation of tranexamic acid therapy to length of stay in the hip fracture population.氨甲环酸治疗与髋部骨折患者住院时间的关系。
Proc (Bayl Univ Med Cent). 2022 Feb 18;35(3):301-304. doi: 10.1080/08998280.2022.2028347. eCollection 2022.
5
The Michigan Experience with Safety and Effectiveness of Tranexamic Acid Use in Hip and Knee Arthroplasty.密歇根州使用氨甲环酸进行髋关节和膝关节置换术的安全性与有效性经验。
J Bone Joint Surg Am. 2016 Oct 5;98(19):1646-1655. doi: 10.2106/JBJS.15.01010.
6
The efficacy of intravenous tranexamic acid administration at induction in definitive hip fracture surgery: Is there a role?静脉注射氨甲环酸在确定性髋部骨折手术诱导时的疗效：是否有作用？
Injury. 2021 Aug;52(8):2361-2366. doi: 10.1016/j.injury.2021.01.032. Epub 2021 Feb 2.
7
The efficacy of tranexamic acid in hip hemiarthroplasty surgery: an observational cohort study.氨甲环酸在半髋关节置换手术中的疗效：一项观察性队列研究。
Injury. 2015 Oct;46(10):1978-82. doi: 10.1016/j.injury.2015.06.039. Epub 2015 Jul 6.
8
Variation in prophylactic tranexamic acid administration among anesthesiologists and surgeons in orthopedic surgery: a retrospective cohort study.骨科手术中麻醉师和外科医生预防性使用氨甲环酸的差异：一项回顾性队列研究。
Can J Anaesth. 2021 Jul;68(7):962-971. doi: 10.1007/s12630-021-01939-x. Epub 2021 Feb 16.
9
Is tranexamic acid use in patients with a hip fracture safe?氨甲环酸在髋部骨折患者中的使用安全吗？
Bone Joint J. 2021 Mar;103-B(3):449-455. doi: 10.1302/0301-620X.103B3.BJJ-2020-1375.R2.
10
Tranexamic acid does not affect intraoperative blood loss or in-hospital outcomes after acetabular fracture surgery.氨甲环酸不会影响髋臼骨折手术后的术中失血量或院内转归。
Eur J Orthop Surg Traumatol. 2022 Feb;32(2):363-369. doi: 10.1007/s00590-021-02985-3. Epub 2021 Apr 23.
引用本文的文献
1
Efficacy and Safety of Orally and Intravenously Administration of Tranexamic Acid in Patients with Elderly Femoral Neck Fracture.口服和静脉给予氨甲环酸治疗老年股骨颈骨折患者的疗效和安全性。
Orthop Surg. 2024 Jul;16(7):1581-1591. doi: 10.1111/os.14089. Epub 2024 May 20.
2
Timing of Major Postoperative Bleeding Among Patients Undergoing Surgery.患者术后大出血的时间。
JAMA Netw Open. 2024 Apr 1;7(4):e244581. doi: 10.1001/jamanetworkopen.2024.4581.
3
Tranexamic Acid in Hip Hemiarthroplasty Surgery: A Retrospective Analysis of Perioperative Outcome.氨甲环酸在半髋关节置换手术中的应用：围手术期结果的回顾性分析
Geriatr Orthop Surg Rehabil. 2023 Jan 13;14:21514593221147817. doi: 10.1177/21514593221147817. eCollection 2023.
4
Tranexamic acid in hip hemiarthroplasty surgery: a systematic review and meta-analysis.氨甲环酸在髋关节半髋关节置换术中的应用：系统评价和荟萃分析。
Eur J Trauma Emerg Surg. 2023 Jun;49(3):1247-1258. doi: 10.1007/s00068-022-02180-x. Epub 2022 Dec 13.
5
The association between perioperative blood transfusions and venous thromboembolism risk following surgical management of hip fractures.髋部骨折手术治疗后围手术期输血与静脉血栓栓塞风险之间的关联。
J Orthop. 2022 Aug 23;34:123-131. doi: 10.1016/j.jor.2022.08.016. eCollection 2022 Nov-Dec.
6
Quality of life and cost-effectiveness analysis of topical tranexamic acid and fibrin glue in femur fracture surgery.局部氨甲环酸和纤维蛋白胶在股骨骨折手术中的生活质量和成本效益分析。
BMC Musculoskelet Disord. 2022 Aug 31;23(1):827. doi: 10.1186/s12891-022-05775-y.
7
The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture.氨甲环酸对髋部骨折患者减少术中和术后失血及血栓栓塞风险的影响。
Open Med (Wars). 2022 Apr 29;17(1):857-862. doi: 10.1515/med-2022-0482. eCollection 2022.
8
Topical tranexamic acid in hip fractures: a randomized, placebo-controlled double-blinded study.髋关节骨折中局部应用氨甲环酸：一项随机、安慰剂对照、双盲研究。
Can J Surg. 2021 Aug 10;64(4):E449-E456. doi: 10.1503/cjs.014220. Epub 2021 Aug 1.
9
Anemia at Presentation Predicts Acute Mortality and Need for Readmission Following Geriatric Hip Fracture.老年髋部骨折患者就诊时的贫血预示急性死亡率和再次入院需求。
JB JS Open Access. 2020 Sep 28;5(3). doi: 10.2106/JBJS.OA.20.00048. eCollection 2020 Jul-Sep.
本文引用的文献
1
Hip fracture trends in the United States, 2002 to 2015.美国 2002 年至 2015 年的髋部骨折趋势。
Osteoporos Int. 2018 Mar;29(3):717-722. doi: 10.1007/s00198-017-4345-0. Epub 2017 Dec 27.
2
Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Hip Fracture.髋关节骨折术后发病率和死亡率的外科医生和医院容量的影响。
J Bone Joint Surg Am. 2017 Sep 20;99(18):1547-1553. doi: 10.2106/JBJS.16.01133.
3
Use of tranexamic acid in dynamic hip screw plate fixation for trochanteric fractures.氨甲环酸在动力髋螺钉钢板固定治疗转子间骨折中的应用。
J Orthop Surg (Hong Kong). 2016 Dec;24(3):379-382. doi: 10.1177/1602400322.
4
Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery.氨甲环酸在冠状动脉旁路移植术患者中的应用
N Engl J Med. 2017 Jan 12;376(2):136-148. doi: 10.1056/NEJMoa1606424. Epub 2016 Oct 23.
5
Hospital Characteristics, Inpatient Processes of Care, and Readmissions of Older Adults with Hip Fractures.医院特征、髋部骨折老年患者的住院护理流程及再入院情况
J Am Geriatr Soc. 2016 Aug;64(8):1656-61. doi: 10.1111/jgs.14256. Epub 2016 Jun 28.
6
Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip: results of a randomised controlled trial.氨甲环酸可减少髋部囊外骨折患者的失血量：一项随机对照试验的结果。
Bone Joint J. 2016 Jun;98-B(6):747-53. doi: 10.1302/0301-620X.98B6.36645.
7
Does tranexamic acid reduce blood transfusion following surgery for inter-trochanteric fracture? A randomized control trial.氨甲环酸能否减少股骨转子间骨折术后的输血？一项随机对照试验。
J Pak Med Assoc. 2015 Nov;65(11 Suppl 3):S17-20.
8
Two Doses of Tranexamic Acid Reduce Blood Transfusion in Complex Spine Surgery: A Prospective Randomized Study.两剂氨甲环酸减少复杂脊柱手术中的输血：一项前瞻性随机研究。
Spine (Phila Pa 1976). 2015 Dec;40(24):E1257-63. doi: 10.1097/BRS.0000000000001063.
9
The efficacy of tranexamic acid in hip hemiarthroplasty surgery: an observational cohort study.氨甲环酸在半髋关节置换手术中的疗效：一项观察性队列研究。
Injury. 2015 Oct;46(10):1978-82. doi: 10.1016/j.injury.2015.06.039. Epub 2015 Jul 6.
10
Red blood cell transfusion for people undergoing hip fracture surgery.髋部骨折手术患者的红细胞输血
Cochrane Database Syst Rev. 2015 Apr 21;2015(4):CD009699. doi: 10.1002/14651858.CD009699.pub2.
Zotero 插件