The effect of new oral anticoagulants and extended thromboprophylaxis policy on hip and knee arthroplasty outcomes: observational study

Arthroplasty Today

Elizabeth Pinder¹  Emeka Oragui¹  Mark Loeffler¹  Paul Aylin²  Alex Bottle² 

[1] Department of Orthopaedics, Colchester General Hospital, Colchester, Essex, UK;Department of Primary Care and Public Health, Dr Foster Unit at Imperial College London, London, UK;

关键词: Thromboprophylaxis;    Hip replacement;    Knee replacement;    Administrative data;   

DOI  :  10.1016/j.artd.2015.03.004

来源: DOAJ

【 摘 要 】

The efficacy and safety of the new oral anticoagulants (NOAC) and the benefits of extended duration thromboprophylaxis following hip and knee replacements remain uncertain. This observational study describes the relations between thromboprophylaxis policies following hip and knee replacements across England's NHS and patient outcomes between January 2008 and December 2011. From the national administrative database, we analyzed mortality, thromboembolic complications, emergency readmission, and bleeding rates for 201,418 hip and 230,282 knee replacements. There were no differences in outcomes for either LMWH or NOAC. We found no advantage in favor of any single anticoagulation policy or in changing policy. This study supports the American Academy of Orthopaedic Surgeons' recommendation that the choice and duration of thromboprophylaxis prophylaxis be decided by the treating surgeon.

【 授权许可】

Unknown