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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.
Injury. 2017 Apr; 48(4):914-919.I

Abstract

BACKGROUND

Uncontrolled 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 METHODS

This 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 30min and 1, 3, and 5days after surgery. Complications were followed up for 4 weeks.

RESULTS

Compared 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 30min (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.

CONCLUSIONS

Hemocoagulase 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).

Authors+Show Affiliations

Department of Surgery, Fujian Provincial Hospital Emergency Center; Provincial Clinical College of Fujian Medical University; Fujian Provincial Emergency Medicine Institute, Fuzhou, China.Department of Surgery, Fujian Provincial Hospital Emergency Center; Provincial Clinical College of Fujian Medical University; Fujian Provincial Emergency Medicine Institute, Fuzhou, China. Electronic address: zhanjunshisci@163.com.Department of Surgery, Fujian Provincial Hospital Emergency Center; Provincial Clinical College of Fujian Medical University; Fujian Provincial Emergency Medicine Institute, Fuzhou, China.Department of Surgery, Fujian Provincial Hospital Emergency Center; Provincial Clinical College of Fujian Medical University; Fujian Provincial Emergency Medicine Institute, Fuzhou, China.Department of Surgery, Fujian Provincial Hospital Emergency Center; Provincial Clinical College of Fujian Medical University; Fujian Provincial Emergency Medicine Institute, Fuzhou, China.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28238301

Citation

Qiu, Meiguang, et al. "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." Injury, vol. 48, no. 4, 2017, pp. 914-919.
Qiu M, Zhang X, Cai H, et al. 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. Injury. 2017;48(4):914-919.
Qiu, M., Zhang, X., Cai, H., Xu, Z., & Lin, H. (2017). 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. Injury, 48(4), 914-919. https://doi.org/10.1016/j.injury.2016.11.028
Qiu M, et al. 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. Injury. 2017;48(4):914-919. PubMed PMID: 28238301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Qiu,Meiguang, AU - Zhang,Xuming, AU - Cai,Hongru, AU - Xu,Zhixian, AU - Lin,Hao, Y1 - 2016/11/27/ PY - 2015/10/21/received PY - 2016/05/27/revised PY - 2016/11/26/accepted PY - 2017/2/28/pubmed PY - 2018/2/2/medline PY - 2017/2/28/entrez KW - Bleeding KW - Blood loss KW - Coagulation KW - Femoral neck fracture KW - Geriatric populations KW - Hemiarthroplasty KW - Hemocoagulase SP - 914 EP - 919 JF - Injury JO - Injury VL - 48 IS - 4 N2 - BACKGROUND: Uncontrolled 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 METHODS: This 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 30min and 1, 3, and 5days after surgery. Complications were followed up for 4 weeks. RESULTS: Compared 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 30min (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. CONCLUSIONS: Hemocoagulase 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). SN - 1879-0267 UR - https://www.unboundmedicine.com/medline/citation/28238301/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-1383(16)30772-0 DB - PRIME DP - Unbound Medicine ER -