Efficacy and safety of perioperative tranexamic acid in elderly patients undergoing trochanteric fracture surgery: a randomised controlled trial

176 patients with trochanteric fractures and scheduled for surgical treatment were randomized to receive 3 doses of intravenous tranexamic acid or placebo (normal saline). Outcomes of interest included peri-operative, obivous and hidden blood loss, post-operative hemoglobin levels, proportion of patients who received red blood cell transfusion, number of transfused red blood cell units per person, and the incidence of adverse events. The results from the trial revealed significantly lower levels of peri-operative, obvious and hidden blood loss in the tranexamic acid group. Post-operative hemoglobin levels were significantly lower in the placebo group on post-operative day 1 and 2. The number patients who received a packed red blood cell transfusion, and the number of packed red blood cell transfusions per patient, were significantly higher in the placebo group. There were no significant differences between the two groups in the incidence of all recorded adverse events.