Quality statement 2: Tranexamic acid for adults

Quality statement

Adults who are having surgery and are expected to have moderate blood loss are offered tranexamic acid.

Rationale

Tranexamic acid can reduce the need for blood transfusion in adults having surgery. This avoids serious risks associated with blood transfusion, for example infection, fluid overload and incorrect blood transfusions being given. It may also reduce the length of hospital stays and the cost to the NHS.

Quality measures

Structure

Evidence of local arrangements to ensure that adults who are having surgery and are expected to have moderate blood loss are offered tranexamic acid.

Data source: Local data collection.

Process

Proportion of adults who are having surgery and are expected to have moderate blood loss who receive tranexamic acid.

Numerator – the number of adults in the denominator who receive tranexamic acid.

Denominator – the number of adults who are having surgery and are expected to have moderate blood loss.

Data source: Local data collection.

Outcome

Blood transfusion rates associated with surgery.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (secondary care services) ensure that systems are in place to offer tranexamic acid to adults who are having surgery and are expected to have moderate blood loss.

Healthcare professionals (doctors, nurses and blood transfusion specialists) offer tranexamic acid to adults who are having surgery and are expected to have moderate blood loss.

Commissioners (clinical commissioning groups) commission services that offer tranexamic acid to adults who are having surgery and are expected to have moderate blood loss.

Adults who are expected to lose more than half a litre of blood during an operation are offered tranexamic acid. This helps blood to clot better and reduces blood loss during surgery.

Source guidance

Definitions of terms used in this quality statement

Moderate blood loss

Adults who are expected to have blood loss greater than 500 ml during surgery, as recorded on the World Health Organization surgical safety checklist.

[NICE's guideline on blood transfusion, recommendation 1.1.5 and the World Health Organization surgical safety checklist]