TRANEXAMIC ACID IN HIP FRACTURE SURGERY AND RISK OF THROMBOEMBOLIC DISEASE

MARIA LOURDES POSADAS MARTINEZ; ET AL

Congreso; 25th Biennial International Congress on Thronbosis; 2018

Background: Tranexamic acid (AT) is an antifibrinolytic. Although it is used to decrease intra- and peri-operative bleeding in hip fracture, it is still controversial in terms of safety because it promotes a state of hypercoagulability. Aim: To evaluate the association between the use of AT in preoperative anesthetic induction and thromboembolic events 90 days after hip fracture surgery. Methods: Retrospective cohort of consecutive adult patients in which hip fracture surgery was performed at the Hospital Italiano de Buenos Aires, between 05/30/2011 and 05/30/2016. Pathological fractures, dislocations and polytraumatisms were excluded. Each patient was followed for 90 days from admission. The events of symptomatic thromboembolism (deep vein thrombosis DVT and pulmonary thromboembolism PET) confirmed at 90 days, transfusion requirement and change of hematocrit before and after surgery were detected. All information was obtained from the secondary database of the repository of electronic medical record data. The association between AT and thrombosis or bleeding was evaluated with a Cox proportional hazards regression model. Results: In the 5-year period, of the 1899 patients eligible for unscheduled surgery secondary to hip fracture, 1714 were included for the analysis. The baseline characteristics global ad by groups with AT and without AT are shown in table1. The incidence of global ETV was 4.6% (n = 79, CI 0.5-5.7%). Within the group with AT 4.62% (71) presented ET and 4.55% (8) in the group without AT. The HR for thrombosis of AT was 1.14 (95% CI 0.52-2.47, p 0.75). Hundred and fifty one patients (9.8%) in the TA group required transfusions and 22.2% (39) in the group without AT (p