{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:56:26Z","timestamp":1781272586805,"version":"3.54.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n To evaluate the association between perioperative tranexamic acid (TXA) use and transfusion rates, perioperative blood loss, and 90-day postoperative complications in patients undergoing intramedullary nailing of femoral shaft fractures.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Multicenter academic and community hospitals participating in the TriNetX research network.<\/jats:p>\n <\/jats:sec>\n \n Patient Selection Criteria:<\/jats:title>\n Adult patients (\u226518 years) who underwent open intramedullary nailing of OTA\/AO 32 (femoral diaphyseal) fractures between 2010 and 2025 were included. Patients with a history of malignant neoplasm, deep vein thrombosis (DVT), and pulmonary embolism (PE) were excluded. Patients were required to have \u226590 days of postoperative follow-up. The TXA group included patients who received perioperative TXA, while the comparison group did not.<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures and Comparisons:<\/jats:title>\n Primary outcomes included the incidence of nonautologous red blood cell transfusion and 90-day postoperative complications. Minor and major complications analyzed were mortality, DVT, PE, myocardial infarction, stroke, and renal failure. Propensity-score matching was performed to balance demographics and comorbidities. Chi-squared tests were used to compare outcomes.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n A total of 7644 patients were included in the study. The mean age was 57.0 \u00b1 23.2 in the TXA group (n = 3,822, 54.1% women) and 57.0 \u00b1 23.2 in the non-TXA group (n = 3,822, 52.3% women). Transfusion rates were lower in the TXA cohort (8.37%) than in the non-TXA cohort (10.47%) [OR 0.78 (0.67\u20130.91);\n P<\/jats:italic>\n = 0.002]. Mortality was also lower in the TXA group (1.31%) than in the non-TXA cohort (2.15%) [OR 0.60 (0.42\u20130.86),\n P<\/jats:italic>\n = 0.005]. No significant differences were observed in DVT [\n P<\/jats:italic>\n = 0.298], PE [\n P<\/jats:italic>\n = 0.611], myocardial infarction [\n P<\/jats:italic>\n = 1.00], stroke [\n P<\/jats:italic>\n = 0.482], renal failure [\n P<\/jats:italic>\n = 0.479], readmissions [\n P<\/jats:italic>\n = 0.772], and reoperations [\n P<\/jats:italic>\n = 0.110].\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Perioperative TXA use during intramedullary nailing for femoral shaft fractures was associated with a reduction in transfusion rates without an increase in short-term complications.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000003159","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T14:08:21Z","timestamp":1770991701000},"page":"348-352","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Use of Tranexamic Acid Is Associated With Reduced Transfusion Rates in Femoral Shaft Fractures: A Propensity-Matched Cohort 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