The Use of Tranexamic Acid in Hip and Pelvic Fracture Surgeries

John D. Adams, Jr, MD, FAAOS; William A. Marshall, MD


J Am Acad Orthop Surg. 2021;29(12):e576-e583. 

In This Article

Potential Benefits of Tranexamic Acid Utilization in Fracture Patients

Hip fracture and trauma patients commonly require blood transfusions, which are associated with numerous adverse outcomes.[1,13–16] The literature clearly shows an increased risk for 90-day mortality[1] and cardiac complications after transfusions.[13] In addition, infectious complications such as urinary tract and surgical site infections are more common in patients receiving transfusions. It has been suggested that this is related to immune modulation secondary to the transfusion.[14,15] For fracture patients, postoperative mobilization is vital for recovery and transfusions may hinder this process. The increased immobility may lead to delirium,[16] longer inpatient stays,[13] and an increased risk for thromboembolism and pneumonia. Therefore, the major benefit in reducing transfusions in hip fracture and orthopaedic trauma patients is avoiding the associated risks and reducing costs.