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Tranexamic acid use during Anesthesia for total joint replacements in Calgary

Does the use of intravenous tranexamic acid (TXA) by Calgary anesthesiologists during total knee and hip replacement procedures affect blood transfusion rates in the 72 hours following surgery?

Current
  • Anesthesiology, Orthopedic Surgery

Don’t transfuse more than one Red cell unit at a time when transfusion is required in stable, non-bleeding patients.

Choosing Wisely Canada Recommendation

Background & Aim

Intravenous (IV) tranexamic acid (TXA) is used in a number of different types of surgeries to reduce blood loss and the need for transfusions. Literature and a local practice protocol support the use of TXA in total hip (THA) and knee arthroplasty (TKA). Calgary anesthesiologists perceive that there is practice variation in the administration of TXA in THA and TKA.  

This project aims to provide the anesthesiologists with:

  • data on their use of IV TXA in THA and TKA
  • patient outcomes surrounding the rate of post-operative RBC transfusions
  • audit-and-feedback intervention

South Health Campus Hospital anesethesiologists received their individual data reports with peer comparator. Site-level data showed variation in the frequency and dose of TXA adminstered

Use of IV TXA from Jan 1, 2014 - Jun 30, 2015
at South Health Campus Hospital

 

Tranexamic acid use during total knee replacement surgery at South Health Campus Jan 1, 2014-Jun 30, 2015 (n=844)

 

Patient outcomes within 72-hours following surgery

Knowledge Translation

At the facilitated feedback session, South Health Calgary Hospital anesthesiologists identified barriers and actions and three key themes:

 

The Physician Learning Program is supporting anesthesiologists by helping generate repeat reports to surgeons and anesthesiologists.

Are you a Calgary anesthesiologist who uses electronic charting?  Are you interested in knowing your TXA use and post-operative transfusion rate?

Join this project by contacting Inelda Gjata, Project Manager, at inelda.gjata2@ucalgary.ca

 

Frequently Asked

How Will You Protect My Data?

The report was generated by the Physician Learning Program (PLP) using Alberta Health Services (AHS) datasets (Anesthesia Manger, OR Manager, Sunrise Clinical Manager, and Calgary Laboratory Services). Confidentiality was of the utmost importance; this data is strictly for the participating anesthesiologists use and reflection. PLP Data reports on individual participating physicians are never shared with AHS, department heads, regulatory bodies or other stakeholders.

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