Table 1.
The general characteristic of the included studies.
| Study | Year | Sample size I/C | Mean age I/C | Fracture type | Surgical methods | Male/female ratio I/C | Tranexamic acid intervention | Control | Prophylactic antithrombotic | Transfusion criteria |
|---|---|---|---|---|---|---|---|---|---|---|
| Sadeghi [35] | 2007 | 32/35 | 51.8/44.4 | Intracapsular and extracapsular fractures | Hemiarthroplasty, plating and nailing | 1.13/2.18 | 15 mg/kg at induction of anaesthesia | Normal saline | NM | NM |
| Emara [36] | 2014 | 20/20 | 56.5/55 | Hip fractures | Hemiarthroplasty | 1.5/1.0 | 10 mg/kg before skin incision followed by 5 mg(kg• h) until the end of the surgery | Normal saline | Clexane | NM |
| Zufferey [32] | 2010 | 57/53 | 81/82 | Femoral neck fractures, intertrochanteric fractures, subtrochanteric fractures | THA, hemiarthroplasty, DHS, IMN | 0.20/0.08 | 15 mg/kg before surgery and 15 mg/kg 3 h later | Placebo | Fondaparinux | 9 g/dl |
| Vijay [34] | 2013 | 45/45 | 48.8/49.3 | Hip fractures | ORIF, hemiarthroplasty, THA | 0.29/0.29 | 500 mg before surgery, 1 mg/(kg• h) following until the completion of surgery | Normal saline | NM | Reduction in haemoglobin exceeding 25% of the preoperative level |
| Baruah [38] | 2016 | 30/30 | 57.7/55.3 | Trochanteric fractures | DHS | 4.0/5.0 | 15 mg/kg before surgery | Normal saline | NM | Hb < 8.5 g/dL or Hct<27% |
| Tengberg [11] | 2016 | 33/39 | 79.8/75.0 | Unstable trochanteric fractures | IMN | 0.27/0.56 | 1 g before surgery, 3 g the following 24 h | NM | Fragmin | Hb < 9.67 g/dL |
| Mohib [31] | 2015 | 50/50 | 69/70 | Intertrochanteric fractures | NM | 0.72/0.92 | 15 mg/kg before surgery, 15 mg/kg 3 h later | Normal saline | Enoxaparin | Hb < 7 g/dL |
| Watts [30] | 2017 | 69/69 | 81.0/82.2 | Femoral neck fractures | THA, hemiarthroplasty | 0.44/0.47 | 15 mg/kg before surgery, 15 mg/kg at wound closure | Normal saline | Low-molecular-weight heparin | Hb < 7 g/dL, Hb<8 g/dL in the presence of persistent symptoms |
| Lei [37] | 2017 | 37/40 | 77.8/79.2 | Intertrochanteric fractures | PFNA | 0.16/0.21 | 1 g before surgery | Normal saline | NM | Preoperative Hb < 9 g/dL |
| Tian [33] | 2018 | 50/50 | 77.7/79.3 | Intertrochanteric fractures | PFNA | 0.61/0.38 | 10 mg/kg 10 min preoperatively and 10 mg/kg 5 h postoperatively | No tranexamic acid | Low-molecular-weight heparin | Postoperative Hb < 9 g/dL |
C = control group; DHS = dynamic hip screw; Hb = haemoglobin; Hct = haematocrit; I = intravenous tranexamic acid group; IMN = intramedullary nail; NM = not mentioned; ORIF = open reduction and internal fixation; PFNA = proximal femoral nail antirotation; THA = total hip arthroplasty.