TXA Increasingly Use in Shoulder Surgery To Reduce Transfusion Risk and Complications

MedicalResearch.com Interview with:

Shawn Anthony, MD, MBA Assistant Professor of Orthopaedics Icahn School of Medicine at Mount Sinai

Dr. Anthony

Shawn Anthony, MD, MBA
Assistant Professor of Orthopaedics
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Rates of total shoulder arthroplasty are increasing, especially with an aging population.  Blood loss requiring transfusion is less common than in total hip or knee replacements but still required in some patients.  Tranexamic acid (TXA) is increasingly used to reduce blood loss in lower extremity arthroplasty but limited data exists for its effectiveness and safety in patients undergoing shoulder arthroplasty. We aimed to utilize national data to assess frequency of use and effectiveness of TXA in shoulder arthroplasty patients.

While utilization of TXA has become very common in total hip and knee arthroplasty, TXA is still used in less than 50% of patients undergoing shoulder arthroplasty as of 2016.  TXA use was associated with a 36% decrease in transfusion risk and a 35% decreased risk for combined complications. Moreover, TXA use was associated with 6.2% shorter hospital stay.

 MedicalResearch.com: What should readers take away from your report?

Response: In this first large scale study assessing TXA use and effectiveness in shoulder arthroplasty patients, we found that TXA utilization is still low among surgeons. TXA should be considered in use in shoulder arthroplasty patients as it decreased transfusion risk and reduced complications.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Future studies should assess whether higher volumes of TXA utilization would translate into more gains on length of stay and cost of hospitalization. In addition, more investigation is warranted as to whether TXA should be prescribed for all patients or whether it should be targeted for patients at high risk for blood loss. 

Citations:

 “Utilization and Real-World Effectiveness of Tranexamic Use In Shoulder Arthroplasty: A Population-Based Study,”
Presented at the 2018 meeting of the American Academy of Orthopaedic Surgeons in New Orleans.

 

 

 

 

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