Inexpensive drug has reduced expensive transfusions for hip replacements
Toronto, July 23, 2014
By Leslie Shepherd
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A bottle of tranexamic acid.
An inexpensive drug is leading to improved quality of care, fewer blood transfusions and big cost savings at St. Michael’s Hospital.
Last October, physicians led by Drs. James Baker, Katerina Pavenski and Gregory Hare started giving the drug TXA, or tranexamic acid, a drug used to prevent excessive blood loss during surgery, to all patients undergoing hip or knee replacements.
Within three months the transfusion rate for patients undergoing hip replacements dropped from 13.7 per cent to 6.6 per cent. The transfusion rate for knee replacements fell from 7.9 per cent to 5.2 per cent. That rate was already low because of the hospital’s commitment to blood management and the Ontario Transfusion Coordinators (ONTraC) program, which is administered by St. Michael’s.
The drug costs $15 per patient, while the average cost of transfusing one unit of blood is $1,200.
In the past, the drug was given only to patients at high risk of requiring a blood tranfusion, in part because of a province-wide shortage of the drug.
“We did more than 650 hip replacements last year so that’s 45 or so transfusions saved,” said Dr. Hare, an anesthesiologist and one of the founders of the hospital’s Centre of Excellence for Patient Blood Management. “Patients go home with higher hemoglobin levels, less anemia and fewer transfusions for just $15.”
About St. Michael's Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.