Tranexamic acid may decrease red blood cell transfusion need in hip fracture surgery

The summary of this review is given below:

• There were 17 reviews about tranexamic acid and nine reviews about iron.
• A total of 36 studies and 3923 participants were included.
• Patients were given tranexamic acid before, during, or after surgery, either intravenously or topically.
• For iron, treatment was given intravenously.

For tranexamic acid:

• The tranexamic acid reduces the need for a blood transfusion. For every 1000 hip fracture patients, 257 do not require a blood transfusion.
• The tranexamic acid probably reduces the volume of transfused PRC.
• There were no reported postoperative delirium, ADL, or quality-of-life outcomes.

For iron:

• There were nine reviews, seven eligible RCTs
• There may be little or no difference according to whether intravenous iron was given in: the number of people who required ABT, the volume of transfused blood, infection or mortality within 30 days.
• Researchers did not report little or no difference in delirium.
• No reviews reported outcomes of cognitive dysfunction, ADL, or HRQoL.

They said that using tranexamic acid before, during, or after hip fracture surgery reduces the need for a blood transfusion.

Treatment with iron may make little to no difference to whether people need a blood transfusion following hip fracture surgery.

Further reading:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013737.pub2/full