One Intraoperative Dose of Tranexamic Acid for Patients Having Primary Hip or Knee Arthroplasty
Bibliographic record
Abstract
BACKGROUND: Multiple studies suggest tranexamic acid reduces blood loss and red cell transfusions in patients undergoing THA or TKA. However, many of the dosing schedules in these studies are not ideally suited for routine application. QUESTIONS/PURPOSES: We asked whether one 20-mg per kg intraoperative dose of tranexamic acid in patients having primary THA or TKA would (1) decrease perioperative blood loss and red cell transfusion rates and (2) be a cost-effective protocol. PATIENTS AND METHODS: We retrospectively reviewed the records of 234 patients operated on from April 1 to June 30, 2007 (before our study protocol) and 259 patients from April 1 to June 30, 2008 with the single-dose protocol. We then compared change in hemoglobin, transfusion rates, hemoglobin at discharge, hospital length of stay, and complications between the two groups. No other routine patient care practices or blood conservation program strategies were altered during this time. RESULTS: We found a reduction in the decrease in hemoglobin in 2008 compared with 2007 for THA and TKA (39 from 46 g/L and 36 from 45 g/L, respectively),which led to a reduction in transfusion rates (3.6% from 13.5% and 2.0% from 13.4%, respectively) and higher hemoglobin levels at discharge [corrected].There were no recorded major adverse events associated with the introduction of this protocol. CONCLUSIONS: One 20-mg per kg intraoperative dose of tranexamic acid reduced the perioperative decrease in hemoglobin and red blood cell transfusion rates in patients having TKA and THA compared with those of a similar cohort of patients in whom the protocol was not used. This weight increment dosing facilitated pharmacy drug preparation, led to minimal dose variability and wastage, and resulted in a substantial estimated cost savings. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".