From research to practice: bridging the implementation gap on the use of tranexamic acid in total knee arthroplasty
Rattachement africain : au, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: The use of intravenous tranexamic acid (TXA), an antifibrinolytic agent, has been shown to effectively reduce total blood loss and transfusion rates in total knee arthroplasty (TKA). The aim of this paper is to evaluate the implementation lag and clinical uptake of the use of TXA for primary TKA after publication of two landmark studies. Additionally, it assessed the efficacy of TXA use in TKA in reducing post-operative blood transfusions and hospital length of stay (LOS). METHODS: A total of 763 patients aged over 18 years of age underwent primary TKA at a level 4 metropolitan hospital in Australia between January 2011 and December 2017. Primary outcome measure was use of TXA at operative induction. Secondary outcome measures were post-operative blood transfusion, haemoglobin levels and in-hospital length of stay. RESULTS: The rate of TXA uptake was ≥ 50% by April-June 2013, 1.5 years following landmark paper publication. TXA use was ≥ 90% by April-June 2015, equating to 3.5 years after landmark publication. For each additional year since publication, the odds that TXA was used in a TKA surgery increased by 254.3%, 95% CI (confidence interval) [195.2%, 334.1%]. There was a negative association between TXA use and blood transfusion rate (p < 0.001), while controlling for other variables. TXA use reduced the odds of blood transfusions occurring by 73.5%, 95% CI [35.8% and 89.8%]. Analysis showed that reduced LOS was seen even after controlling for post-operative blood transfusion (p < 0.05). CONCLUSION: The implementation lag from research to clinical practice, using ≥ 90% TXA use in TKA as a proxy, was 3.5 years. The use of TXA reduced LOS and blood transfusion rate in TKA patients.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- From research to practice: bridging the implementation gap on the use of tranexamic acid in total knee arthroplasty
- Date Crossref
- 30/01/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Hunter New England Local Health District pays non établi dans la noticeÉtablissement de santé
-
Central Coast Local Health District pays non établi dans la noticeÉtablissement de santé
-
Brigham Young University pays non établi dans la noticeUniversité ou école supérieure
-
Physical Sciences (United States) pays non établi dans la noticeEntreprise
-
Hunter New England Health District pays non établi dans la noticeInstitution
-
College of Life Sciences Department of Exercise Sciences pays non établi dans la noticeUniversité ou école supérieure
-
College of Computational Department of Statistics pays non établi dans la noticeUniversité ou école supérieure
Hunter New England Local Health District, Central Coast Local Health District et Brigham Young University, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.