The effect of single-dose intravenous tranexamic acid in simultaneous bilateral total hip arthroplasty: a retrospective study
Bibliographic record
Abstract
BACKGROUND: Simultaneous bilateral total hip arthroplasty (SBTHA) has been associated with high blood loss and transfusion risk. We sought to analyze the effectiveness of a single intravenous dose of tranexamic acid (TXA) on blood loss and transfusion rates in SBTHA. METHODS: We retrospectively reviewed data from patients who underwent SBTHA with a single dose of TXA (20 mg/kg) before incision. We analyzed hematological parameters and transfusion rates. We performed a multivariate logistic regression analysis to identify independent risk factors for blood transfusion. RESULTS: We included 92 patients with a median age of 60 (interquartile range [IQR] 52 to 68) years. Of these, 48 (52.2%) were male. The median follow-up time was 4.6 (IQR 3.2 to 7.0) years. Six patients had transfusions, for a transfusion rate of 6.5%. The median hemoglobin levels before surgery, on postoperative day 1, and on the day of discharge were 144 (IQR 135 to 154) g/L, 107 (IQR 93 to 118) g/L, and 101.5 (IQR 90 to 111) g/L, respectively. Longer surgical time (adjusted odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01 to 1.07) and lower preoperative platelet count (adjusted OR 1.01, 95% CI 1.00 to 1.03) were significant risk factors for transfusion. Male sex (adjusted OR 0.04, 95% CI 0.004 to 0.40) and younger age (adjusted OR 0.92, 95% CI 0.86 to 0.99) were protective factors. CONCLUSION: We found a low transfusion rate (6.5%) after SBTHA among patients administered a single dose of 20 mg/kg of TXA, with young patients and male patients at lower risk of requiring transfusions. Our results suggest that performing SBTHA with current blood management protocols is effective in patients with bilateral hip disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".