{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:37:04Z","timestamp":1787755024682,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tranexamic acid (TXA) is considered safe and efficacious for elective total joint arthroplasty. However, evidence of TXA\u2019s safety in high-risk patients with hip fracture requiring nonelective arthroplasty has been lacking. This study aimed to assess whether TXA administration to high-risk patients with a hip fracture requiring arthroplasty increased the risk of thrombotic complications or mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All patients who underwent hip hemiarthroplasty (HHA) or total hip arthroplasty (THA) for displaced femoral neck fractures between 2011 and 2019 at 4 sites within 1 hospital system were retrospectively identified. Patients were grouped by risk (high-risk or low-risk) and TXA treatment (with or without TXA). Propensity scores were used for risk adjustment in comparisons between surgery with and without TXA for only the high-risk group (n = 1,066) and the entire population (n = 2,166). Differences in the occurrence of postoperative mortality, deep venous thrombosis, pulmonary embolism, myocardial infarction, and stroke within 90 days of hip arthroplasty were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>TXA administration was not associated with an increased risk of thrombotic complications or mortality within 90 days in either high-risk or all-patient groups. Specifically, among 1,066 matched high-risk patients who did not or did receive TXA, there were no significant differences in mortality (14.82% and 10.00%; p = 0.295), deep venous thrombosis (3.56% and 3.04%; p = 0.440), pulmonary embolism (2.44% and 1.96%; p = 0.374), myocardial infarction (3.38% and 2.14%; p = 0.704), or stroke (4.32% and 5.71%; p = 0.225).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In our review of 1,066 propensity-matched high-risk patients undergoing hip arthroplasty for displaced femoral neck fractures, we found that TXA administration (compared with no TXA administration) was not associated with an increased risk of mortality, deep venous thrombosis, pulmonary embolism, myocardial infarction, or stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.21.00172","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T15:01:02Z","timestamp":1630076462000},"page":"1880-1889","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["Tranexamic Acid Was Not Associated with Increased Complications in High-Risk Patients with Hip Fracture Undergoing Arthroplasty"],"prefix":"10.2106","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8657-2004","authenticated-orcid":false,"given":"Steven B.","family":"Porter","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9727-6756","authenticated-orcid":false,"given":"Aaron C.","family":"Spaulding","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0645-4762","authenticated-orcid":false,"given":"Christopher M.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3604-6954","authenticated-orcid":false,"given":"Benjamin K.","family":"Wilke","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1679-0046","authenticated-orcid":false,"given":"Mark W.","family":"Pagnano","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2398-1724","authenticated-orcid":false,"given":"Matthew P.","family":"Abdel","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"issue":"2","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.arth.2014.08.022","article-title":"Venous thromboembolism and mortality associated with tranexamic acid use during total hip and knee arthroplasty","volume":"30","author":"Duncan","year":"2015","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.arth.2019.08.015","article-title":"Tranexamic acid administration is not associated with an increase in complications in high-risk patients undergoing primary total knee or total hip arthroplasty: a retrospective case-control study of 38,220 patients","volume":"35","author":"Porter","year":"2020","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1136\/rapm-2018-000024","article-title":"Tranexamic acid in total joint arthroplasty: the endorsed clinical practice guides of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society","volume":"44","author":"Fillingham","year":"2019","journal-title":"Reg Anesth Pain Med."},{"issue":"11","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"e14564","DOI":"10.1097\/MD.0000000000014564","article-title":"Tranexamic acid can reduce blood loss in patients undergoing intertrochanteric fracture surgery: a meta-analysis","volume":"98","author":"Jiang","year":"2019","journal-title":"Medicine (Baltimore)."},{"key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jot.2019.03.007","article-title":"The efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis","volume":"19","author":"Qi","year":"2019","journal-title":"J Orthop Translat."},{"issue":"1","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1186\/s12891-019-2670-5","article-title":"Efficacy and safety of tranexamic acid in geriatric hip fracture with hemiarthroplasty: a retrospective cohort study","volume":"20","author":"Xie","year":"2019","journal-title":"BMC Musculoskelet Disord."},{"issue":"4","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/os.12511","article-title":"Efficacy and safety of tranexamic acid in intertrochanteric fractures: a single-blind randomized controlled trial","volume":"11","author":"Zhou","year":"2019","journal-title":"Orthop Surg."},{"issue":"3","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1359\/jbmr.061113","article-title":"Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025","volume":"22","author":"Burge","year":"2007","journal-title":"J Bone Miner Res."},{"issue":"14","key":"bib9-20250430","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1001\/jama.2009.1462","article-title":"Incidence and mortality of hip fractures in the United States","volume":"302","author":"Brauer","year":"2009","journal-title":"JAMA."},{"issue":"2","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1002\/pst.433","article-title":"Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies","volume":"10","author":"Austin","year":"2011","journal-title":"Pharm Stat."},{"issue":"5","key":"bib12-20250430","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1111\/1475-6773.12182","article-title":"Methods for constructing and assessing propensity scores","volume":"49","author":"Garrido","year":"2014","journal-title":"Health Serv Res."},{"issue":"4","key":"bib13-20250430","first-page":"69","article-title":"Reducing bias in cancer research: application of propensity score matching","volume":"29","author":"Reeve","year":"2008","journal-title":"Health Care Financ Rev."},{"issue":"7","key":"bib14-20250430","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/BOT.0000000000000837","article-title":"Tranexamic acid safely reduced blood loss in hemi- and total hip arthroplasty for acute femoral neck fracture: a randomized clinical trial","volume":"31","author":"Watts","year":"2017","journal-title":"J Orthop Trauma."},{"key":"bib15-20250430","article-title":"Tranexamic acid safely reduces hidden blood loss in patients undergoing intertrochanteric fracture surgery: a randomized controlled trial","author":"Zhang","year":"2020","journal-title":"Eur J Trauma Emerg Surg."},{"issue":"1","key":"bib16-20250430","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1093\/bja\/aep314","article-title":"tranexamic acid in hip-fracture surgery (THIF) study. Tranexamic acid in hip fracture surgery: a randomized controlled trial","volume":"104","author":"Zufferey","year":"2010","journal-title":"Br J Anaesth."},{"issue":"1","key":"bib17-20250430","doi-asserted-by":"crossref","first-page":"2309499019887995","DOI":"10.1177\/2309499019887995","article-title":"Tranexamic acid in hip fracture surgery: a systematic review and meta-analysis","volume":"28","author":"Haj-Younes","year":"2020","journal-title":"J Orthop Surg (Hong Kong)."},{"issue":"1","key":"bib18-20250430","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5152\/j.aott.2020.01.88","article-title":"Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: a meta-analysis of randomized controlled trials","volume":"54","author":"Luo","year":"2020","journal-title":"Acta Orthop Traumatol Turc."},{"issue":"1","key":"bib19-20250430","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.otsr.2019.10.015","article-title":"Postoperative outcomes of tranexamic acid use in geriatric trauma patients treated with proximal femoral intramedullary nails: a systematic review and meta-analysis","volume":"106","author":"Xing","year":"2020","journal-title":"Orthop Traumatol Surg Res."},{"issue":"2","key":"bib20-20250430","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s11239-019-02034-1","article-title":"The efficacy and safety of tranexamic acid in the treatment of intertrochanteric fracture: an updated meta-analysis of 11 randomized controlled trials","volume":"50","author":"Yu","year":"2020","journal-title":"J Thromb Thrombolysis."},{"key":"bib21-20250430","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jor.2020.01.040","article-title":"Utilization, effectiveness, and safety of tranexamic acid use in hip fracture surgery: a population-based study","volume":"20","author":"Cheung","year":"2020","journal-title":"J Orthop."},{"issue":"3","key":"bib22-20250430","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1302\/0301-620X.103B3.BJJ-2020-1288.R1","article-title":"Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial","volume":"103-B","author":"Nikolaou","year":"2021","journal-title":"Bone Joint J."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.21.00172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:36:24Z","timestamp":1787751384000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.21.00172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,27]]},"references-count":21,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.21.00172","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,27]]}}}