TXA seen as less expensive treatment option for anemic patients undergoing TJA
Investigators of this retrospective study found that for patients with preoperative anemia who underwent total joint arthroplasty, treatment with tranexamic acid and packed red blood cells was significantly less expensive than treatment with either IV iron supplementation or IV erythropoietin.
Researchers performed a cost analysis to compare the material costs of tranexamic acid (TXA) and packed red blood cells with the theoretical administration of IV iron supplementation and IV erythropoietin in 243 patients who underwent total joint arthroplasty. Investigators categorized patients into either the anemic group and the non-anemic group according their hemoglobin status. Patients with anemia were further categorized according to arthroplasty procedure. Investigators used the Fisher exact tests to compare the transfusion rates among patients with or without anemia overall, and patients with or without this condition who underwent either total hip or total knee arthroplasty.
Overall, 45 patients (18.5%) had preoperative anemia. Results showed the overall transfusion rate for patients with anemia who underwent total joint arthroplasty was 6.7%. Among patients who underwent total hip arthroplasty, five units of packed red blood cells were used in three patients with anemia and two units were given to two patients who did not have anemia. Investigators found no patients in the total knee arthroplasty group need a transfusion.
Researchers noted the combined cost for packed red blood cells and TXA was $5,317.08. Using the best-case scenario without the need for packed red blood cells postoperatively, investigators noted the cost for treatment with either iron supplementation or erythropoietin ranged between two- to 17-times more than TXA treatment. According to researchers, 50 additional units of packed red blood cells would need to be transfused in order for the cost of treatment with TXA to be similar to that of either iron supplementation or erythropoietin treatment. ‒ by Monica Jaramillo
Disclosures: Phan reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.