The impact of hemocoagulase for improvement of coagulation and reduction of bleeding in fracture-related hip hemiarthroplasty geriatric patients: A prospective,single-blinded,randomized, controlled study |
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| Affiliation: | 1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China;2. Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China;1. Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China;2. Hebei Medical University, Shijiazhuang, Hebei, 050051, China;1. Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan;2. Department of Orthopaedics, Srinakharinwirot University, Nakhon Nayok, Thailand;3. Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan;4. Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan;1. Department of Orthopaedic Surgery, Keimyung University Dongsan Medical Center, Daegu, South Korea;2. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea;3. Department of Orthopaedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea;4. Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea;5. Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea;6. Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju, South Korea;7. Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan, South Korea;1. Department of Surgery, University Medical Centre Utrecht, The Netherlands;2. Utrecht Traumacenter, Utrecht, The Netherlands;1. Monash University MBBS Program, Monash University, Melbourne, Australia;2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;3. National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia;4. Department of Orthopaedic Surgery, The Alfred Hospital, Melbourne, Australia;5. Department of Physiotherapy, Monash University, Melbourne, Australia;6. Department of Orthopaedics, The Northern Hospital, Melbourne, Australia;7. Department of Orthopaedics, Medical Centre Alkmaar, The Netherlands;8. Monash Health, Melbourne, Australia |
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| Abstract: | BackgroundUncontrolled bleeding is associated with poor outcomes and mortality in geriatric patients undergoing hemiarthroplasty. Hemocoagulase agkistrodon is a hemocoagulative, anti-hemorrhagic enzyme complex from Deinagkistrodon acutus snake venom. This study aimed to investigate the efficacy of hemocoagulase agkistrodon on coagulation and bleeding outcomes in fracture-related hemiarthroplasty.Patients and methodsThis was a prospective, single-blinded, randomized controlled trial carried out between October 2013 and September 2014 in 96 geriatric patients undergoing hemiarthroplasty for unilateral femoral neck fracture. Patients were administrated hemocoagulase agkistrodon (n = 48) or normal saline (n = 48). Intraoperative blood loss, transfusion volume and rate, and drainage were assessed. Hemoglobin (Hb) and coagulation parameters (prothrombin time [PT], thrombin time [TT], plasma fibrinogen [FIB], and activated partial thromboplastin time [aPTT]) were recorded preoperatively and 30 min and 1, 3, and 5 days after surgery. Complications were followed up for 4 weeks.ResultsCompared to controls, hemocoagulase patients exhibited lower intraoperative blood loss (P < 0.01) and postoperative blood loss, total drainage, mean transfusion volume, and transfusion rates (all P < 0.05), with lower aPTT at 30 min (P < 0.05). No significant differences in postoperative FIB were observed. Controls exhibited significantly higher PP and TT on day 1, and Hb on days 1, 3, and 5 (P < 0.05). No serious complications were reported.ConclusionsHemocoagulase reduced blood loss and transfusion in fracture-related hip hemiarthroplasty without increasing short-term adverse event rates. In geriatric populations, hemocoagulase could be used for limiting bleeding and related complications.Trial registration: This trial is registered in the Chinese Clinical Trial Register (no. ChiCTR-TRC-14004379) |
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| Keywords: | Hemocoagulase Blood loss Femoral neck fracture Hemiarthroplasty Bleeding Coagulation Geriatric populations |
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