ABO Blood Group Is a Predictor for the Development of Venous Thromboembolism After Total Joint Arthroplasty

2017 ◽  
Vol 32 (9) ◽  
pp. S254-S258 ◽  
Author(s):  
Jared M. Newman ◽  
Matthew V. Abola ◽  
Alexandra Macpherson ◽  
Alison K. Klika ◽  
Wael K. Barsoum ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Blood Group ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Abo Blood Group

Impact of Weight-Band Dosing of Tinzaparin for Venous Thromboembolism Prophylaxis on Persistent Wound Drainage in Adult Patients Undergoing Hip and Knee Arthroplasty

2021 ◽  
pp. 106002802110242
Author(s):  
Cassandra Cooper ◽  
Ouida Antle ◽  
Jennifer Lowerison ◽  
Deonne Dersch-Mills ◽  
Ashley Kenny
Keyword(s):  
Body Weight ◽  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Thromboembolism Prophylaxis ◽  
Wound Drainage ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

Background: Persistent wound drainage and venous thromboembolism (VTE) are potential complications of total joint arthroplasty, and these risks can be challenging to balance in clinical practice. Anecdotal observation has suggested that following joint arthroplasty, persistent wound drainage occurs more frequently with higher body weight and higher doses of tinzaparin when compared with lower body weight and lower doses of tinzaparin. Objective: The overall purpose of this study was to describe the impact of a tinzaparin weight-band dosing table for VTE prophylaxis on wound healing, thrombosis, and bleeding outcomes in patients undergoing total joint arthroplasty. Methods: This retrospective chart review included patients who underwent total hip or knee arthroplasty and received tinzaparin for thromboprophylaxis per their weight-banding category. The primary outcome was the incidence of persistent wound drainage. Secondary outcomes include the occurrence of VTE and clinically important bleeding during hospital admission. Results: A total of 231 patients were included in the analysis. There was no significant difference in persistent wound drainage between the 3 weight categories, and there were no differences in rates of VTE or clinically important bleeding. Concurrent use of low-dose acetylsalicylic acid was associated with a 3-fold increased risk of persistent wound drainage (risk ratio = 3.35; 95% CI = 2.14-5.24; P = 0.00003). Conclusion and Relevance: In joint arthroplasty patients, we observed no significant difference in rates of persistent wound drainage between various weight categories receiving different weight-banded doses of tinzaparin. Our results do not suggest that the current weight-band dosing table for tinzaparin needs to be adjusted to optimize patient outcomes.

Venous Thromboembolism Prophylaxis After Total Joint Arthroplasty

Orthopedics ◽  
2015 ◽  
Vol 38 (4) ◽  
pp. 252-263 ◽  
Author(s):  
Michael A. Flierl ◽  
Michael J. Messina ◽  
Justin J. Mitchell ◽  
Craig Hogan ◽  
Robert D’Ambrosia
Keyword(s):  
Venous Thromboembolism ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Thromboembolism Prophylaxis ◽  
Venous Thromboembolism Prophylaxis

Cost-Effective Prophylaxis Against Venous Thromboembolism After Total Joint Arthroplasty: Warfarin Versus Aspirin

2015 ◽  
Vol 30 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Reza Mostafavi Tabatabaee ◽  
Mohammad R. Rasouli ◽  
Mitchell G. Maltenfort ◽  
Javad Parvizi
Keyword(s):  
Venous Thromboembolism ◽  
Total Joint Arthroplasty ◽  
Cost Effective ◽  
Joint Arthroplasty ◽  
Effective Prophylaxis

ABO blood group as a potential risk factor for venous thromboembolism in acutely injured patients

2011 ◽  
Vol 105 (01) ◽  
pp. 5-13 ◽  
Author(s):  
Sarah Muellner ◽  
Elliott Haut ◽  
Michael Streiff ◽  
John Holcomb ◽  
Bryan Cotton
Keyword(s):  
Risk Factor ◽  
Venous Thromboembolism ◽  
Blood Group ◽  
Abo Blood Group ◽  
Trauma Patients ◽  
Major Health Problem ◽  
Increase Risk ◽  
Significant Burden ◽  
Injured Patients ◽  
Von Willebrand

SummaryVenous thromboembolism (VTE) is a major health problem that results in a significant burden on hospitals and patients. VTE screening and prophylaxis protocols in trauma patients vary significantly among hospitals and providers. In addition, many patients develop VTE even in the absence of “high-risk” categories. Therefore, more research is needed to better understand and prevent VTE in these patients. ABO blood group has long been recognised as a risk factor for VTE, but its contribution to VTE risk in the trauma setting is poorly studied. This paper reviews the literature describing the link between ABO blood group and VTE risk and the implications for VTE screening and prophylaxis in trauma patients. The effect of ABO blood groups are genotype-dependent – in most populations the A1 allele and the B allele increase risk while A2, O1, and O2 decrease risk of VTE. ABO group is a major determinant of plasma von Willebrand factor (vWF) and factor VIII levels, thereby (partially) mediating the effects of ABO blood group on VTE susceptibility. In addition, ABH antigens alter plasma levels of vWF via clearance mechanisms, which are in turn mediated by ADAMTS13. ABO blood group is a risk factor for VTE that warrants further investigation in trauma patients.

scholarly journals Simplifying Thromboprophylaxis Could Improve Outcomes in Orthopaedic Surgery

Thrombosis ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-5
Author(s):  
Richard J. Friedman
Keyword(s):  
Venous Thromboembolism ◽  
Potential Barrier ◽  
Total Joint Arthroplasty ◽  
Orthopaedic Surgery ◽  
Joint Arthroplasty ◽  
Knee Surgery ◽  
Bleeding Complications ◽  
Conservative Approach ◽  
Total Hip

Venous thromboembolism is a serious complication after total hip or knee surgery, and there is a well-established clinical need for thromboprophylaxis. However, in a large number of cases adequate administration of thromboprophylaxis does not seem to occur after total joint arthroplasty. A major challenge in the management of thromboprophylaxis is to balance the benefits of treatment with the risks, including bleeding complications. Another potential barrier to the optimal use of thromboprophylaxis could be the inconvenience of currently available agents. Many surgeons therefore adopt a conservative approach towards thromboprophylaxis. Simplifying therapy with more convenient, efficacious, and safe anticoagulants could change attitudes to anticoagulant use and improve adherence to thromboprophylactic guidelines.

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