Authors: Ponsworno K V et al.
Cureus 17(10): e95672, October 2025. DOI: 10.7759/cureus.95672
This retrospective study assessed the impact of tranexamic acid (TXA) use in 158 patients undergoing surgical management for neck of femur (NOF) fractures at a UK teaching hospital. Among the patients, 91% received TXA perioperatively. Those given TXA had markedly lower transfusion rates (22.2% vs 50%) and a smaller postoperative hemoglobin drop (17.1 ± 13.4 g/L vs 22.8 ± 17.2 g/L) compared with those who did not receive TXA. Regression analysis confirmed TXA as an independent protective factor against transfusion need, while female sex, higher ASA grade, and extracapsular fracture type predicted increased transfusion risk. Importantly, there were no significant increases in thromboembolic events or 30-day mortality, indicating TXA was safe in this high-risk, elderly population.
What You Should Know
Tranexamic acid reduced transfusion rates and perioperative blood loss in patients with hip fractures without increasing the risk of thrombosis or mortality. The results support making TXA a routine, cost-effective part of perioperative management for NOF fracture surgery.
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