Safety and efficacy of single dose IV tranexamic acid in geriatric hip fracture fixation surgery

Background Tranexamic acid is commonly used for bleeding control. This study investigated the effect of a single dose of tranexamic acid on blood loss and packed cell transfusion rates in geriatric hip fracture fixation surgery. Methods This retrospective cohort study involved a total of 218 patients who were admitted to a single trauma centre in Hong Kong between January 2023 and July 2024. The treatment group was given 1 g of intravenous tranexamic acid upon induction of anaesthesia. Intra-operative blood loss, packed cell transfusion rate, post-operative haemoglobin change and length of stay were compared. The incidence of post-operative thromboembolic complications (cerebrovascular accident, myocardial infarction, deep vein thrombosis and pulmonary embolism) was also compared. Results There was no significant difference in terms of intra-operative blood loss, packed cell transfusion rate, post-operative haemoglobin drop, thromboembolic events and length of stay. Conclusion One gram intravenous tranexamic acid did not influence blood loss or transfusion requirement, nor increase thromboembolic events.