Efficacy and safety of combined treatment with tranexamic acid and erythropoietin to improve perioperative anemia and blood loss during surgery for intertrochanteric fractures
Objective:To assess the effectiveness and safety of combined treatment with tranexamic acid(TXA)and erythropoietin (EPO)during the surgery for intertrochanteric fracture(IF). Methods:A total of 174 patients with IF underwent surgery admitted to the Affiliated Jiangning Hospital of Nanjing Medical University from January 2018 to January 2023 were enrolled in this study. The patients were randomly divided into 3 groups:control group(Group A,n=62),TXA alone group(Group B,n=57),and TXA combined with EPO group(Group C,n=55). Perioperative total blood loss,obvious blood loss and hidden blood loss in the three groups were calculated separately. The blood transfusion rate and blood transfusion volume,haemoglobin(Hb)levels,hospitalization day,and complications such as thrombosis were recorded. Results:There was no significant difference in Hb levels between three groups on admission. The Hb levels in Group C were significantly improved compared to the other two groups before surgery,2 and 5 days after surgery(P < 0.05). The total blood loss,transfusion rate,and transfusion volume in Group C were all lower than those in Group A,and the differences were statistically significant(P < 0.05). There was no statistically significant difference in the incidence of thrombosis and other complications among three groups(P > 0.05). Conclusion:The combined use of TXA and EPO intravenously and locally during surgery significantly reduces perioperative blood loss and blood transfusion rate,shortens hospital stays,lowers hospitalization costs,and does not increase the risk of complications such as thrombosis,in patients with IF.