Tranexamic acid reduces blood loss in intertrochanteric fractures: A meta-analysis from randomized controlled trials

Background:This meta-analysis aims to assess the efficacy and safety of tranexamic acid for reducing blood loss and transfusion requirements in patients with intertrochanteric fractures.Methods:We conduct electronic searches of Medline (1966-2017.09), PubMed (1966-2017.09), Embase (1980-2017.09), ScienceDirect (1985-2017.09), and the Cochrane Library. Only randomized controlled trials (RCTs) are included. The quality assessments are performed according to the Cochrane systematic review method. Fixed/random-effect model is used according to the heterogeneity tested by I-2 statistic. Meta-analysis is performed using Stata 11.0 software.Results:A total of 4 RCTs are retrieved involving 514 participants. The present meta-analysis indicated that there were significant differences between groups in terms of total blood loss (weighted mean differences=-131.49, 95% confidence interval (CI): -163.63 to -99.35, P=.00), hemoglobin decline (weighted mean differences=-0.31, 95% CI, -0.44 to -0.19, P=.00), and transfusion rate (risk differences=-1.11, 95% CI, -0.19 to -0.04, P=.00). In addition, no increased risk of adverse effects was identified in both groups.Conclusion:Local administration of tranexamic acid is associated with a reduced total blood loss, postoperative hemoglobin decline, and transfusion requirements in patients with intertrochanteric fractures. High-quality RCTs are still required for further investigation.