Cochrane · systematic review · CD013499
Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for hip, pelvic and long bone fractures
Gibbs, VN, Geneen, LJ, Champaneria, R, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
InjuriesAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
11
No studies
3
Included studies
NR
No studies 3 · 21.4%Ungraded 0 · 0%Very low 7 · 50%Low 4 · 28.6%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Intravenous tranexamic acid versus placebo
Population: people undergoing definitive fixation of hip, pelvic and long bone fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Risk of requiring allogeneic blood transfusion (30 days post‐surgery) Intravenous tranexamic acid vs placebo | RR 0.48 [0.34, 0.69] | 6 studies · 457 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortality (30 days post‐surgery) Intravenous tranexamic acid vs placebo | Peto OR 0.38 [0.05, 2.77] | 2 studies · 147 participants | Low Downgraded: risk of bias, imprecision |
Re‐operation due to bleeding (7 days post‐surgery) ‐ not reported Intravenous tranexamic acid vs placebo | no estimate extracted | NR | No studies |
Risk of myocardial infarction (30 days post‐surgery) Intravenous tranexamic acid vs placebo | RD 0 | 2 studies · 199 participants | Low Downgraded: risk of bias, imprecision |
Risk of cerebrovascular accident/stroke (30 days post‐surgery) Intravenous tranexamic acid vs placebo | RD 0 | 3 studies · 324 participants | Low Downgraded: risk of bias, imprecision |
Risk of deep vein thrombosis (30 days post‐surgery) Intravenous tranexamic acid vs placebo | Peto OR 2.15 [0.22, 21.35] | 4 studies · 329 participants | Very low Downgraded: risk of bias, imprecision |
Risk of suspected serious drug reactions (30 days post‐surgery) Intravenous tranexamic acid vs placebo | RD 0 | 2 studies · 185 participants | Very low Downgraded: risk of bias, imprecision |
Topical tranexamic acid versus placebo
Population: people undergoing definitive fixation of hip, pelvic and long bone fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Risk of requiring allogeneic blood transfusion (30 days post‐surgery) Topical tranexamic acid vs placebo | RR 0.31 [0.08, 1.22] | 2 studies · 101 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality (30 days post‐surgery) Topical tranexamic acid vs placebo | RD 0 | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Re‐operation due to bleeding (7 days post‐surgery) ‐ not reported Topical tranexamic acid vs placebo | no estimate extracted | NR | No studies |
Risk of myocardial infarction (30 days post‐surgery) Topical tranexamic acid vs placebo | Peto OR 0.15 [0, 7.62] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Risk of cerebrovascular accident/stroke (30 days post‐surgery) Topical tranexamic acid vs placebo | RD 0 | 1 study · 65 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Risk of deep vein thrombosis (30 days post‐surgery) Topical tranexamic acid vs placebo | Peto OR 1.11 [0.07, 17.77] | 2 studies · 101 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Risk of suspected serious drug reactions (30 days) ‐ not reported Topical tranexamic acid vs placebo | no estimate extracted | NR | No studies |