To evaluate the association between tranexamic acid administration route and postoperative outcomes in patients undergoing shoulder arthroplasty.
Approach:
Data Source: Data were derived from the TriNetX Research Network, a global electronic health record database containing information on over 195 million patients.
Cohort Selection: A retrospective cohort study was conducted identifying adult patients who underwent primary total shoulder arthroplasty between 2005 and 2025, stratified by route of tranexamic acid administration.
Study Population and Propensity Matching: Patients were matched 1:1 using propensity scores to minimize baseline differences between those receiving IV and oral tranexamic acid.
Outcomes: Primary outcomes included 90-day postoperative complications, while secondary outcomes included postoperative laboratory values.
Statistical Analysis: Statistical analyses were performed on propensity score–matched cohorts, with significance set at P < 0.05.
Key Findings:
Before matching, the IV TXA cohort included 45,537 patients and the oral TXA cohort included 5,723 patients.
After matching, 5,722 patients remained in each group with well-balanced baseline characteristics.
Interpretation:
This study compares the effectiveness and safety of oral versus IV tranexamic acid in shoulder arthroplasty.
Limitations:
Data were derived from a single electronic health record database, which may limit generalizability.
The study was retrospective and may be subject to biases inherent in such designs.
Conclusion:
This study provides a comparison of the effectiveness of oral and IV tranexamic acid in reducing postoperative complications in shoulder arthroplasty.
