DOS 2017

DOS Kongressen 2017 ·

153

Tranexamic acid does not increase the postopera-

tive risk of cardiovascular events or death after

total hip arthroplasty surgery. A population-based

study from the Danish Hip Arthroplasty Register

Alexander Dastrup, Anton Pottegård, Jesper Hallas, Søren Overgaard

Department of Orthopaedic Surgery, Odense University Hospital; Clinical Phar-

macology and Pharmacy, University of Southern Denmark; Clinical Pharmacolo-

gy and Pharmacy, University of Southern Denmark; Department of Orthopedic

Surgery and Traumatology, Odense University Hospital

Background:

There remain concerns that routine use of tranexamic acid (TXA)

during primary total hip arthroplasty (THA) might increase the postoperative

risk of cardiovascular events. We aimed to estimate the risks of primarily venous

thromboembolism (VTE) and secondarily; deep vein thrombosis (DVT), pulmo-

nary embolism (PE), myocardial infarction (MI), ischemic stroke and all-cause

mortality within 30 days after surgery.

Purpose / Aim of Study:

To determine the safety of perioperative tranexamic

acid during primary THA in Denmark.

Materials and Methods:

Using the Danish Hip Arthroplasty Register, the Dan-

ish National Patient Register and the Danish National Database of Prescriptions

we included a total of 45,290 patients with primary THA from 2006 to 2013.

38,586 patients received perioperative TXA while 6704 did not. 1:2 Propensity

score matching on age, gender, year of surgery, known risk factors for car-

diovascular disease, the Elixhauser Comorbidity Index and income resulted in a

final cohort of 6002 and 12,004 individuals, unexposed and exposed to TXA

respectively. Cox regression survival analysis was used to calculate hazard ratios

(HR) and 95% confidence intervals (CI) for the validated outcomes.

Findings / Results:

In the matched cohort we found no statistically significant

effect on VTE (HR = 1.18; 95% CI, 0.83- 1.68), DVT (HR = 1.15; 95% CI,

0.78-1.68), PE (HR = 1.50; 95% CI, 0.60-3.78), MI (HR = 0.83; 95% CI, 0.46-

1.50), ischemic stroke (HR = 0.89; 95% CI, 0.39-2.01) or all-cause mortality

(HR = 0.73; 95% CI, 0.41-1.28).

Conclusions:

Use of TXA is not associated with the risk of VTE, DVT, PE, MI,

ischemic stroke or all-cause mortality after primary THA. Perioperative use of

TXA for primary THA seems safe.

No conflicts of interest reported

105.