Even Patients with a Normal Hemoglobin Level Benefit from Tranexamic Acid

    Tranexamic acid (TXA) is commonly used to reduce the risk of transfusions following total hip and total knee arthroplasty, but do all patients really need it? Is there a hemoglobin level at which an otherwise healthy patient would not see any benefit from the drug but would potentially be exposed to the risk of a thromboembolic event?

    According to a study from Mayo Clinic, the answer is no – all patients can benefit from TXA, regardless of hemoglobin level.

    The study results were presented at the recent annual meeting of the Mid-America Orthopaedic Association.

    The researchers compared outcomes of patients who did and did not receive TXA at 5 hemoglobin levels: >15 g/dL, >14 g/dL, >13 g/dL, >12 g/dL, and >11 g/dL.

    Even patients with the highest hemoglobin (>15 g/dL) who received TXA fared better than those with the same hemoglobin level who did note receive the drug, with the transfusion rates of 0.5% and 4.5%, respectively (P=0.0086). In patients with the lowest hemoglobin level (>11 g/dL), the transfusion rate was 4.7% for those who received TXA and 18.7% for those who did not receive the drug (P<0.0001).

    We asked Daniel R. Whiting, MD, the study’s lead author, to discuss the results and clinical implications of this research. Click the image above to hear his comments.

    Producer and Director: Michael Bugera; Post Production: Charles Maynard


    Whiting DR, Duncan CM, Smith HM, Sierra RJ. Tranexamic Acid Benefits Total Joint Arthroplasty Patients Regardless of Preoperative Hemoglobin Value (Paper 210). Presented at the Mid-America Orthopaedic Association Annual Meeting, April 22-25, 2015, Hilton Head Island, South Carolina.