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The Efficacy and Aafety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-Analysis.
Bo Deng
Taizhou Hospital of Zhejiang Province
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9849-5659
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: The efficacy and safety of topical fibrin sealant (FS) compared with tranexamic acid (TXA) to reduce blood loss after total hip arthroplasty (THA) is not clear. A meta-analysis was conducted to evaluate the efficacy and safety of topical FS versus topical or intravenous TXA for treatment of
Method: We searched electronic databases, including PubMed, EMBASE, and the Cochrane Library to identify studies up to March 2020. The references included in articles were also checked for additional potentially-relevant studies. The language of publication was limited to English. The endpoints included the mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and thrombotic events. Our meta-analysis was performed according to the Guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement. The data of the included studies were analyzed using RevMan 5.3.
Results: A total of four studies (two randomized controlled trials and two non-randomized controlled trials) met the inclusion criteria. Our meta-analysis demonstrated that TXA administration led to significantly different outcomes in terms of transfusion rate (RD = -0.12, 95% CI (-0.23, -0.00), P = 0.05, I2 = 74%) and postoperative hemoglobin levels (WMD = -0.47, 95% CI (-0.74, -021), P = 0.0005, I2 = 3%) compared with topical application of FS in patients undergoing THA. No significant difference was seen in total calculated blood loss (WMD = -86.22, 95% CI (-99.13, -73.31), P < 0.00001, I2 = 96%) or complication rate (RR = 0.98, 95% CI (-99.13, -73.31), P = 0.45, I2 = 0%) between the two groups.
Conclusions: TXA administration can effectively decrease the transfusion rate and result in higher postoperative hemoglobin levels without increasing the rate of infection.
Keywords
Fibrin sealant, tranexamic acid, total hip arthroplasty, blood loss, meta-analysis
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CURRENT STATUS: Under Review
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Posted 15 Jun, 2020
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Received 04 Jul, 2020
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On 21 Jun, 2020
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On 19 Jun, 2020
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Editor invited
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On 12 Jun, 2020
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Orthopedic Surgery
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This preprint is under consideration at Journal of Orthopaedic Surgery and Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
The Efficacy and Aafety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-Analysis.
Bo Deng
Taizhou Hospital of Zhejiang Province
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9849-5659
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 15 Jun, 2020
No community comments so far
Review #1 received
Received 04 Jul, 2020
Reviewer #1 agreed
On 21 Jun, 2020
Editor assigned
On 19 Jun, 2020
Reviewers invited
Invitations sent on 19 Jun, 2020
Editor invited
On 18 Jun, 2020
Submission checks complete
On 12 Jun, 2020
First submitted
On 09 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: The efficacy and safety of topical fibrin sealant (FS) compared with tranexamic acid (TXA) to reduce blood loss after total hip arthroplasty (THA) is not clear. A meta-analysis was conducted to evaluate the efficacy and safety of topical FS versus topical or intravenous TXA for treatment of
Method: We searched electronic databases, including PubMed, EMBASE, and the Cochrane Library to identify studies up to March 2020. The references included in articles were also checked for additional potentially-relevant studies. The language of publication was limited to English. The endpoints included the mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and thrombotic events. Our meta-analysis was performed according to the Guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement. The data of the included studies were analyzed using RevMan 5.3.
Results: A total of four studies (two randomized controlled trials and two non-randomized controlled trials) met the inclusion criteria. Our meta-analysis demonstrated that TXA administration led to significantly different outcomes in terms of transfusion rate (RD = -0.12, 95% CI (-0.23, -0.00), P = 0.05, I2 = 74%) and postoperative hemoglobin levels (WMD = -0.47, 95% CI (-0.74, -021), P = 0.0005, I2 = 3%) compared with topical application of FS in patients undergoing THA. No significant difference was seen in total calculated blood loss (WMD = -86.22, 95% CI (-99.13, -73.31), P < 0.00001, I2 = 96%) or complication rate (RR = 0.98, 95% CI (-99.13, -73.31), P = 0.45, I2 = 0%) between the two groups.
Conclusions: TXA administration can effectively decrease the transfusion rate and result in higher postoperative hemoglobin levels without increasing the rate of infection.
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Figure 2
Figure 3
Figure 4
Figure 5
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Figure 7