Cost Benefit Analysis of Topical Tranexamic Acid in Primary Total Hip and Knee Arthroplasty
Section snippets
Materials and Methods
Following IRB approval, 591 primary, consecutive total joint arthroplasties performed by 5 orthopaedic surgeons at a single institution between March 2012 and March 2013 were retrospectively reviewed. September 1st 2012 marked the day that each of these surgeons began to administer topical TXA to all total joint patients intraoperatively. The months of August and September of 2012 were excluded from the study to prevent overlap of the experimental and control groups. The proportion of patients
Results
There was no statistically significant difference in demographics between the pre and post TXA groups. The control group (280 patients) consisted of 169 TKA and 111 THA; TKA made up 60.4% of the control group cases. The experimental TXA group (311 patients) consisted of 185 TKA and 126 THA; TKA made up 59.5% of the experimental group cases. Demographics are summarized in Table 1. This shows a nearly identical patient population in terms of gender, age, BMI, preoperative hemoglobin, and surgical
Discussion
Our institution has seen a marked reduction in transfusion rates since the implementation of topical TXA in total joint arthroplasty. We noted a 12% reduction in postoperative transfusion and an 18% reduction in the rate of RBC units transfused. The postoperative hemoglobin levels were significantly higher in the TXA group. The use of TXA saved $8372.66 per 100 patients based on transfusion cost alone. This amount does not factor in the cost of transfusion-related total joint complications.
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Does patient blood management represent good value for money?
2023, Best Practice and Research: Clinical AnaesthesiologyTranexamic acid achieves less blood loss volume of in primary shoulder arthroplasty: a systematic review and meta-analysis of level I randomized controlled trials
2021, JSES Reviews, Reports, and TechniquesA break-even analysis of tranexamic acid for prevention of periprosthetic joint infection following total hip and knee arthroplasty
2021, Journal of OrthopaedicsCitation Excerpt :While previous studies have investigated the cost-effectiveness of TXA for TJA in several different settings, none have accounted for differences in rates of PJI. After adjusting for the cost of TXA, Tuttle et al. (2014) found that its use led to savings of $87.73 per patient, just based on the cost of transfusions alone.22 The administration of TXA also had other notable benefits, including increased rates of discharge to home (instead of a skilled nursing facility) and higher post-operative hemoglobin.
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2014.01.031.
Reprint requests: John R. Tuttle, 593 Eddy St. Providence, RI 02903.