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In the UK, tranexamic acid is recommended for all surgical procedures where expected blood loss exceeds 500 ml. However, the optimal dose, route and timing of administration are not known. This study aimed to evaluate current practice of peri-operative tranexamic acid administration. Patients undergoing primary total hip arthroplasty, total knee arthroplasty or unicompartmental knee arthroplasty during a 2-week period were eligible for inclusion in this prospective study. The primary outcome was the proportion of patients receiving tranexamic acid in the peri-operative period. Secondary outcomes included: dose, route and timing of tranexamic acid administration; prevalence of pre- and postoperative anaemia; estimated blood loss; and red blood cell transfusion rates. In total, we recruited 1701 patients from 56 NHS hospitals. Out of these, 1523 (89.5%) patients received tranexamic acid and of those, 1052 (69.1%) received a single dose of 1000 mg intravenously either pre- or intra-operatively. Out of the 1701 patients, 571 (33.6%) and 1386 (81.5%) patients were anaemic (haemoglobin

Original publication




Journal article



Publication Date





1050 - 1058


anaemia, arthroplasty, blood loss, tranexamic acid, transfusion, Aged, Aged, 80 and over, Anemia, Antifibrinolytic Agents, Arthroplasty, Replacement, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Blood Loss, Surgical, Blood Transfusion, Cohort Studies, Erythrocyte Transfusion, Female, Humans, Lower Extremity, Male, Middle Aged, Perioperative Care, Postoperative Complications, Prospective Studies, Tranexamic Acid