Effect of Tranexamic Acid on Transfusion and Blood Loss in Acetabular Fracture Surgery: A Randomized Clinical Trial

Acetabular fracture surgery may be associated with complications such as blood loss during and after surgery, which can lead to increased morbidity and mortality. Tranexamic acid (TXA) reduces bleeding by reducing local fibrinolysis. This study aimed to evaluate the efficacy of TXA in reducing transfusion and blood loss in acetabular fracture surgery.
Overall 51 patients were randomly divided into two groups TXA and control. Preoperative and postoperative hemoglobin, intraoperative and postoperative bleeding volume, as well as deep vein thrombosis (DVT) symptoms, were recorded in both groups.
Out of 51 patients, 41 (80.4%) were male, and 10 (19.6%) were female. Bleeding volume during surgery was 386.53±76.88 in the TXA group and 854.00±369.94 in the control group, indicating a significant difference (P<0.001). Also, 21 patients underwent packed cell transfusion, of whom19 were in the control group and two in the TXA group (P<0.001). The mean duration of surgery was 125.38±14.41 minutes in the TXA group and 156.40±16.74 minutes in the control group (P <0.001). Postoperative bleeding volume was reported as 105.76± 51.62 in the TXA group and 230.00± 47.87 in the control group (P<0.001). Furthermore, TXA did not increase the incidence of DVT.
Intravenous injection of TXA in acetabular fractures significantly reduced the need for blood transfusions, blood loss, and duration of surgery. Meanwhile, it did not increase the risk of DVT.