Journal
JOURNAL OF ARTHROPLASTY
Volume 28, Issue 8, Pages 137-139Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2013.04.054
Keywords
tranexamic acid; economic impact; hip and knee arthroplasty
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Tranexamic acid (TA) has been shown to reduce perioperative blood loss and blood transfusion. While concern remains about the cost of antifibrinolytic medication, we hypothesized that routine use of tranexamic acid would result in lower direct hospital total cost by decreasing costs associated with blood transfusion, laboratory testing, and room & board. Patients with an American Society of Anesthesiologists (ASA) class II or less undergoing primary total hip or knee arthroplasty at a single institution during 2007-2008 were retrospectively reviewed. The estimated mean direct hospital total cost, operating room, blood/lab, room & board, and pharmacy costs were compared between patients who did and did not receive TA. The study population included 1018 patients, and 580 patients received TA. The mean direct total cost of hospitalization with and without TA was $ 15,099 and $ 15,978 (P < .0002) respectively, a difference of $ 879. The only increased cost associated with TA was the pharmacy cost which was $ 921 versus $ 781 (P < .0001). The routine use of tranexamic acid TA was associated with lower mean direct hospital total costs after primary total hip and knee arthroplasty as the increase in pharmacy costs was more than offset by cost savings in other categories. (C) 2013 Elsevier Inc. All rights reserved.
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