PURPOSE: @entity927 ( @entity928 ) therapy can reduce red blood cell (RBC) transfusion; however, this therapy remains underutilized in many surgical @entity1 populations. We assessed whether implementation of a protocol to facilitate universal administration of @entity928 in @entity1 undergoing total hip or knee arthroplasty would reduce the incidence of RBC transfusion without increasing adverse clinical outcomes. METHODS: We implemented a quality of care policy to provide universal administration of intravenous @entity928 at a dose of 20 mg  kg(-1) iv to all eligible @entity1 undergoing total hip or knee arthroplasty from October 21, 2013 to April 30, 2014. We compared data from an equal number of @entity1 before and after protocol implementation (n = 422 per group). The primary outcome was RBC transfusion with secondary outcomes including postoperative hemoglobin concentration (Hb) and length of hospital stay. Adverse events were identified from the electronic medical records. Data were analyzed by a Chi square test and adjusted logistic and linear regression analysis. RESULTS: Implementation of the protocol resulted in an increase in @entity928 utilization from 45.8% to 95.3% [change 49.5%; 95% confidence interval (CI), 44.1 to 54.5; P < 0.001]. This change was associated with a reduction in the rate of RBC transfusion from 8.8% to 5.2%, (change -3.6%; 95% CI, -0.1 to -7.0; P = 0.043). Pre- and post-protocol mean [standard deviation (SD)] Hb values were similar, including the nadir Hb prior to RBC transfusion [72 (8) g  L(-1) vs 70 (8) g  L(-1), respectively; mean difference -1 g  L(-1); 95% CI, -3 to 5; P = 0.569]. Length of stay was not altered, and no increase in adverse events was observed. CONCLUSIONS: Implementation of a perioperative @entity928 protocol was associated with both an increase in @entity928 use and a reduction in RBC transfusion following hip or knee arthroplasty. Adverse events and length of hospital stay were not influenced by the protocol.

Universal XXXX therapy to minimize transfusion for major joint arthroplasty: a retrospective analysis of protocol implementation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity928 :: ('CHEBI:36088', 'Chemical') :: ['TXA'] @entity927 :: ('MESH:D014148', 'Chemical') :: ['Tranexamic acid']
@entity927 :: (MESH:D014148,Chemical) :: ['tranexamic acid']
