Tranexamic acid and fibrin spray equally effective in reducing blood loss following THA .
Este estudo foi identificado como tendo um impacto potencialmente elevado.
A métrica de Alto Impacto da OE, baseada em IA, estima a influência que um artigo poderá ter, integrando sinais da revista em que foi publicado e do conteúdo científico do próprio artigo.
Desenvolvido com recurso ao mais avançado processamento de linguagem natural, o modelo High Impact da OE prevê com maior precisão o desempenho futuro de um estudo em termos de citações do que o fator de impacto da revista por si só.
Isto permite o reconhecimento precoce de investigação clinicamente significativa e ajuda os leitores a concentrarem-se nos artigos com maior probabilidade de moldar a prática futura.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(2):19 Acta Orthop. 2011 Dec;82(6):660-3. Epub 2011 Oct 1766 patients undergoing primary unilateral cemented total hip replacement were randomized to receive treatment with either tranexamic acid, fibrin spray, or to the control group which received neither. The primary objective of this trial was compare total blood loss between these treatments. The results indicated that both tranexamic acid and fibrin spray were more effective in reducing the total blood loss than the control group. Neither of these active treatments were superior to one another.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
1/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
3/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
Various methods to achieve blood conservation following arthroplasty procedures of the lower limb have been used. Previous studies have shown that both tranexamic acid and fibrin spray are effective in reducing blood loss following total hip arthoplasties; however, direct comparisons of these two treatment have yet to be assessed.
Qual era a principal questão de investigação?
What is the effectiveness of fibrin spray compared to tranexamic acid on total blood loss, in patients undergoing total hip arthroplasty, measured post-operatively?
- The calculated median total blood loss values are as follows: Control group= 1.20L (95% CI: 0.82-1.4; IQR: 0.50), tranexamic acid group=0.93L (95% CI: 0.69-1.1; IQR: 0.35), and the fibrin spray group=0.82L (95% CI 0.72-1.1; IQR: 0.33).
- There was no significant difference in the total blood loss when comparing the two active treatment groups (p=1.0).
- The tranexamic group had significantly lower blood loss compared to the control group (22% lower, p=0.02).
- The fibrin spray group had a significantly lower blood loss than the control group (32% lower, p=0.02).
De que é que me devo lembrar mais?
In patients undergoing total hip arthroplasty, both tranexamic acid and fibrin spray significantly reduced total blood loss in comparison to the control group. There were no differences in blood loss between tranexamic acid and fibrin spray groups.
Como é que isto afectará o tratamento dos meus doentes?
The use of either fibrin spray or tranexamic acid appear to be safe and efficacious treatments for blood conservation following total hip arthroplasty and should be considered as future treatment options. Further research is required to determine if these results extend to patients with uncemented total hip arthroplasties or arthroplasties in other joints.
AVISO LEGAL
O conteúdo desta página destina-se apenas a fins informativos e não pretende substituir o aconselhamento, diagnóstico ou tratamento médico profissional. Se necessitar de tratamento médico, procure sempre o conselho do seu médico ou dirija-se ao serviço de urgência mais próximo. As opiniões, crenças e pontos de vista expressos pelos indivíduos no conteúdo encontrado nesta página não reflectem as opiniões, crenças e pontos de vista da OrthoEvidence.
0 de 4 artigos mensais GRATUITOS desbloqueados
