Preoperative dose of intravenous tranexamic acid safely reduces blood loss and transfusion in patients undergoing hip hemiarthroplasty for femoral neck fracture. A randomized controlled trial

The objectives were to evaluate the effectiveness and safety of a single preoperative dose of intravenous tranexamic acid (TXA) in reducing perioperative blood loss and requirement for transfusion in patients undergoing hip hemiarthroplasty for femoral neck fracture. A double-blind randomized controlled trial was conducted in 140 patients with hip fracture. After randomization, 68 patients received a single dose of 1 gr of intravenous TXA at the start of the surgery (TXA group), and 72 received a placebo treatment (placebo group). TXA group had a significant decrease in blood loss (p < 0.001) and requirement for transfusion (p < 0.001) compared with the placebo group. There were seven thromboembolic events, all in the placebo group (p = 0.014). Mortality within 1-year postoperatively was not significantly different between groups (p = 0.297).The use of a single dose of intravenous TXA at the start of the surgery significantly reduces blood loss and requirement for transfusion without increasing the risk of thromboembolic events in patients with femoral neck fracture undergoing hip hemiarthroplasty.