Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Efficacy of erythropoietin combined with tranexamic acid in reducing perioperative blood loss and blood transfusion rate in elderly patients with femoral intertrochanteric fractures

Dongyang Zhao, Jin Chen, Zhigang Xu, Liqing Tao, Hualiang Jiang, Wei Cui

¹Department of Orthopedic, Suzhou Xiangcheng People's Hospital, Suzhou, China.

For correspondence:- Wei Cui Email: Kingfantasy@163.com Tel:+8651269571800

Accepted: 24 June 2023 Published: 31 July 2023

Citation: Zhao D, Chen J, Xu Z, Tao L, Jiang H, Cui W. Efficacy of erythropoietin combined with tranexamic acid in reducing perioperative blood loss and blood transfusion rate in elderly patients with femoral intertrochanteric fractures. Trop J Pharm Res 2023; 22(7):1457-1462 doi: 10.4314/tjpr.v22i7.14

© 2023 The authors.
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Abstract

Purpose: To investigate the efficacy of exogenous recombined human erythropoietin (rhEPO), combined with tranexamic acid (TXA) and administered by different routes, in the treatment of elderly patients with femoral intertrochanteric fractures.

Methods: 252 elderly patients in Suzhou Xiangcheng People's Hospital were randomly divided into groups (A, B and C), with 84 patients in each group. All the patients were given rhEPO and iron sucrose, followed by TXA which was administered via topical injection at the fracture site in Group A, via intravenous infusion in Group B, and via topical injection combined with intravenous infusion in Group C. The perioperative actual total blood loss, occult blood loss, hematocrit (HCT), platelet count (PLT), hemoglobin (Hb), and activated partial thromboplastin time (APTT) were assessed. Also evaluated were prothrombin time (PT), fibrinogen (FIB), blood transfusion rate and incidence of deep venous thrombosis (DVT) of the lower limbs. The results were then compared among the three groups.

Results: Perioperative total blood loss and occult blood loss as well as the blood transfusion rate were lowest in Group C, followed by Group B and then Group A. The differences were statistically significant (p < 0.05). The HCT and Hb levels were highest in Group C, followed by Group B and then Group A (p < 0.05).

Conclusion: Multi-modal administration of drugs (rhEPO combined with topical injection and intravenous infusion of TXA) is effective in treating elderly patients with femoral intertrochanteric fractures. The strategy efficiently reduces perioperative blood loss and blood transfusion rate, and also improves relevant blood biochemical indicators.

Keywords: Femoral intertrochanteric fracture, Elderly, Erythropoietin, Tranexamic acid, Blood loss, Blood transfusion rate