3rd International Congress on Surgery and Anesthesia
September 02 | Virtual Event
DyQuan Kearney
Howard University College of Medicine USA, USA
Abstract:
Background: Tranexamic acid (TXA) is widely used in orthopedic surgeries to reduce blood
loss, but concerns persist regarding its association with thromboembolic complications. This
study aimed to compare the incidence of thromboembolic events in patients undergoing
spine, knee, or hip surgeries with and without perioperative TXA administration.
Methods: Using TriNetX, a federated electronic health record network, we identified 236,482
matched patients in each cohort: one receiving TXA and one not receiving TXA during orthopedic
surgery. Propensity score matching was performed on demographics and comorbidities.
Outcomes included the incidence and frequency of thromboembolic events within one
day post-surgery. Statistical analyses included risk ratio, odds ratio, Kaplan-Meier survival
analysis, and t-tests.
Results: The TXA group demonstrated a lower incidence of thromboembolic events (0.064%)
compared to the non-TXA group (0.092%), corresponding to a risk ratio and odds ratio of 1.43
(95% CI: 1.16–1.76, p = 0.001). Kaplan-Meier analysis revealed significantly higher event-free
survival in the TXA group (99.94% vs. 99.91%, p = 0.001). The average number of event instances
per patient was not significantly different (TXA: 1.066 vs. No TXA: 1.055; p = 0.676).
Conclusions: This large-scale, real-world analysis demonstrates that TXA use in orthopedic
surgery is associated with a significantly reduced risk of early postoperative thromboembolic
events. The results support TXA’s continued use in perioperative protocols, with no evidence of
increased event burden among affected patients. Future studies should evaluate longer-term
outcomes and specific surgical subtypes.