Warfarin cessation is non-essential in patients undergoing total knee arthroplasty—a case-control study

Journal of Orthopaedic Surgery and Research

Raymond Randle³  Nathan Schaefer¹  Michael Dan²  Alfred Phillips¹ 

[1] Gold Coast University Hospital, Southport 4215, QLD, Australia;Maitland Hospital, Maitland 2320, NSW, Australia;John Flynn Private Hospital, Tugun 4224, QLD, Australia

关键词: Complications;    Bridging;    Cessation;    Continuation;    Warfarin;    Anticoagulation;    Total knee arthroplasty;   

Others  :  1144200
DOI  :  10.1186/s13018-015-0153-4

 received in 2014-09-26, accepted in 2015-01-03,  发布年份 2015

【 摘 要 】

Background

Warfarinised patients frequently present for total knee arthroplasty (TKA). Current practice of heparin ‘bridging’ is potentially cumbersome and hazardous. The research question is if cessation of warfarin is necessary for TKA.

Methods

The study design was a retrospective case–control series of 61 warfarinised patients and 61 control patients undergoing TKA. TKA was performed by the senior author using a medial parapatellar approach without tourniquet. The target perioperative international normalised ratio (INR) for warfarinised patients was 2–2.2. Primary outcomes were changes in haemoglobin, transfusion requirements and complication rates.

Results

There was no statistically significant difference between control and warfarin group in mean perioperative Hb (g/L) (pre-op 140 vs 141, day 0 115 vs 115, day 1 108 vs 111, P = 0.63), transfusion rates (14.75% vs 9.83%, P = 0.58), total complication rate (9.8% vs 9.8%, P = 0.75), demographics, range of motion or length of stay. There was a statistically significant higher use of the re-infusion drain in the warfarinised group (47.5% vs 24.6%, P = 0.014).

Conclusion

This study supports the hypothesis that warfarin cessation is non-essential in patients undergoing TKA. This data is applicable to a patient group using re-infusion drains. Limitations of this study are typical of a small non-controlled observational study.

【 授权许可】

   
2015 Phillips et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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