Cost benefit analysis of topical tranexamic acid in primary total hip and knee arthroplasty

J Arthroplasty. 2014 Aug;29(8):1512-5. doi: 10.1016/j.arth.2014.01.031. Epub 2014 Feb 3.

Abstract

The purpose of this study was to provide a cost-benefit analysis of topical tranexamic acid (TXA) in primary total hip and knee arthroplasty patients. A retrospective cohort of 591 consecutive patients, 311 experimental and 280 control, revealed a transfusion rate reduction from 17.5% to 5.5%, increased postoperative hemoglobin, and decreased delta hemoglobin without an increase in adverse events (all P < 0.001). This led to saving $83.73 per patient based on transfusion costs alone after accounting for the cost of TXA. Hospital disposition to home compared to subacute nursing facility was also significantly increased by 9.3% (P < 0.02). We conclude that topical TXA reduces transfusion rate, increases home disposition, and reduces cost in primary hip and knee arthroplasty.

Keywords: financial; primary arthroplasty; tranexamic acid; transfusion.

MeSH terms

  • Administration, Topical
  • Aged
  • Antifibrinolytic Agents / administration & dosage
  • Antifibrinolytic Agents / economics
  • Antifibrinolytic Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / economics*
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / economics*
  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion / economics
  • Cost Savings
  • Cost-Benefit Analysis
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tranexamic Acid / administration & dosage
  • Tranexamic Acid / economics*
  • Tranexamic Acid / therapeutic use*

Substances

  • Antifibrinolytic Agents
  • Hemoglobins
  • Tranexamic Acid