Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effect of Tranexamic Acid on Transfusion Rates in Intertrochanteric Hip Fractures: A Prospective, Double-Blind, Randomized Controlled Trial
Brief Summary: The goal of this study is to determine if the use of tranexamic acid, a safe and effective antifibrinolytic, in patients with intertrochanteric hip fractures will result in a reduction in blood transfusion rates. Treatment will be administered pre-operatively as well as at the time of surgical incision. The primary outcome will be need for blood transfusion. Secondary outcomes will include calculated perioperative blood loss, length of stay, cost of inpatient care, and rate of adverse events, including DVT, PE, infection, MI, cerebrovascular event, need for re-hospitalization or re-operation and 30 day mortality.


Options:
A: Inclusion Criteria:

All of the following criteria must be met to be eligible:

1. 18 years of age or older
2. Diagnosis of hip fracture (Intracapsular, Intratrochanteric or Subtrochanteric) requiring surgical repair
3. Patient/surrogate decision maker provide signed informed consent

Exclusion Criteria:

Participants cannot be included in this study if any of the following criteria apply:

1. Patient has documented renal failure with glomerular filtration rate of \<30ml/min/1.73m2
2. Documented allergy to tranexamic acid
3. Current use of hormone replacement therapy
4. Acquired disturbances of colour vision
5. Refusal of blood products
6. Pre-operative use of anticoagulant therapy (Coumadin, heparin \< 5 days of surgery, fibrinolytic disorders requiring intraoperative anti-fibrinolytic treatment)
7. Coagulopathy (pre-operative platelet count \<150,000/mm3, International Normalized Ratio (INR) \>1.4, prolonged Partial Thromboplastin Time (PTT) \>1.4x normal)
8. Hematuria
9. Acute coronary syndrome within 6 weeks of fracture
10. Any history of venous thromboembolism
11. Any intraoperative surgical/medical/anesthetic complications i.e.: myocardial infarction or neurovascular injury occurring prior to application of the tranexamic acid
12. Pregnant or lactating
13. Any major medical or psychiatric disorder that in the opinion of the investigator, might prevent the subject from completely participating in the study or interfere with the interpretation of the study results
14. Unable/unwilling to provide informed consent
B: Inclusion Criteria:

* Age ≥ 18 years,
* Osteoporotic Fractures of the upper end of the femur requiring surgical repair.
* Preoperative hemoglobin between 9.5 and 13 g/dl.
* Patient or relative signed informed consent or inclusion thanks to urgent inclusion procedure

Exclusion Criteria:

* Bone marrow disease or ongoing treatment (such as chemotherapy), which could interfere with bone marrow erythropoiesis,
* Known allergy or counter-indication to iron and/or to tranexamic acid,
* Uncontrolled arterial hypertension,
* Recent iron infusion (within one week),
* Blood transfusion within one week before inclusion or preoperative blood transfusion already scheduled,
* Any patient who cannot be transfused or has refused consent for a blood transfusion,
* Bedridden or very dependent patient (equivalent to GIR 1 or 2 class).
* Non-affiliation to French health care coverage,
* Adult patient protected under the law (guardianship),
* Pregnancy.
C: Inclusion Criteria:

* Age \> 18 years.
* Scheduled for primary unilateral hip arthroplasty
* Able to give consent

Exclusion Criteria:

* Allergy towards adrenaline
* Current treatment with: ADP receptor inhibitors or Vitamin K antagonists (within 5 days), Factor Xa inhibitors or Thrombin inhibitors (within 1 day), heparin (excluding low molecular weight heparin for perioperative thromboprophylaxis).
* Current treatment with tricyclic antidepressants
* Use of MAO inhibitors (within previous 14 days) or COMT inhibitors (within 2 days).
* Acute coronary syndrome / myocardial infarction within the previous 6 months.
* not willing to accept blood transfusion
* Participation in other clinical trial within previous 30 days
* Women of childbearing age (without menopause for at least 12 months)
* Glaucoma
* Pheochromocytoma
* Low serum K+ (\< 3.0 mmol/L)
* Thyrotoxicosis
* Digoxin intoxication
* Alcohol og drug abuse (investigators judgement)
D: Inclusion Criteria:

* Intertrochanteric Hip Fracture
* Age \>18

Exclusion Criteria:

* Preoperative use of anticoagulant (Clopidogrel, Warfarin, Enoxaparin, Fondaparinux, Rivaroxaban
* Allergy to Tranexamic Acid
* History of intracranial hemorrhage or significant GI or retroperitoneal bleed requiring hospitalization
* History of thromboembolic event (Stroke, Deep Vein Thrombosis, Pulmonary Embolism)
* History of cirrhosis or evidence of hepatic (AST/ALT \>60) or renal dysfunction (Cr \>1.5 or GFR \<30)
* Coronary stents or prior diagnosis of CAD
* Color blindness

Answer: D