Total Hip Arthroplasty Patients with Distinct Postoperative Fibrinolytic Phenotypes Require Different Antifibrinolytic Strategies
, Bowen Chen 1,†, Xiangdong Wu 2, Han Wang 3, Xiaohai Zuo 1, Yiting Lei 1,* and Wei Huang 1,*
Round 1
Reviewer 1 Report
1. This retrospective study is limited by the non-randomized design, especially postoperative (Group A, no TXA), (Group B, TXA) (lines 69 - 70).
2. TEG® Hemostasis Analyzer is one of the most sensitive and specificity? (lines 125 - 126)
3. Is there a connection between TXA and fibrinolytic shutdown? (lines 209 - 213)
4. The use of TXA in patients with fibrinolytic shutdown increased the mortality?
5. Please explain why LY30 remain a more reliable parameter to guide the administration of TXA? (lines 224 - 225)
Author Response
Please see the attachment.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Thank you for an interesting paper. The possibility that a significant portion of our patients may not benefit from, and may even be harmed by, TXA administration is an important one. I would be curious to know whether fibrinolytic shutdown occurs at the time of insult (surgery), or at what time period post-operatively, as this may have implications for timing of post-op TXA administration.
Some of your post-op care is what I would consider non-standard (72h of TXA administration, 3 days of post-op antibiotic coverage). In particular, I would like to see you comment on whether the pre- and intra-op doses of TXA are useful even in the fibrinolytic group.
I would also like to know how accessible and expensive the TEG/LY30 testing is, and whether you recorded any DVT/PE in any patients.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
