Inheritable Risk Factors for Venous Thromboembolism in Patients Undergoing Lower Extremity Total Joint Arthroplasty

Author(s):  
D. Alex Stroh ◽  
Kimona Issa ◽  
Samik Banerjee ◽  
Jesse Allert ◽  
Eiman Shafa ◽  
...  
2019 ◽  
Vol 34 (11) ◽  
pp. 2774-2779 ◽  
Author(s):  
Jared A. Warren ◽  
Kavin Sundaram ◽  
Atul F. Kamath ◽  
Robert M. Molloy ◽  
Viktor E. Krebs ◽  
...  

2021 ◽  
pp. 106002802110242
Author(s):  
Cassandra Cooper ◽  
Ouida Antle ◽  
Jennifer Lowerison ◽  
Deonne Dersch-Mills ◽  
Ashley Kenny

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.


2013 ◽  
Vol 28 (9) ◽  
pp. 1499-1504 ◽  
Author(s):  
Andrew J. Pugely ◽  
John J. Callaghan ◽  
Christopher T. Martin ◽  
Peter Cram ◽  
Yubo Gao

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

2021 ◽  
Author(s):  
Pin Pan ◽  
Zitao Zhang ◽  
Xiaofeng Zhang ◽  
Qing Jiang ◽  
Zhihong Xu

Abstract Background: Regular monitoring of serum potassium after total joint arthroplasty (TJA) is a routine examination, which can detect abnormal serum potassium and reduce adverse events timely caused by postoperative hypokalemia. In this study, we aimed to investigate the incidence and risk factors of hypokalemia after primary total hip and knee replacement.Methods: This study included patients who underwent unilateral total knee or hip arthroplasty in our department from April 2017 to March 2018. The serum potassium level before and after operation was collected and retrospectively analyzed. The differences in age, BMI and other factors between hypokalemia patients and non-hypokalemia patients at different time points after surgery were compared, and then the risk factors of postoperative hypokalemia were analyzed based on multiple logistic regression.Results: The total incidence of postoperative hypokalemia was 53.1%, while the respective rate on the first, third and fifth postoperative day was 12.5%, 40.7% and 9.6%. The serum potassium level on the first, third and fifth postoperative day was 3.84±0.32mmol/l, 3.59±0.34mmol/l and 3.80±0.32mmol/l, while among which, the level on the third day was the lowest (p=0.015). The independent risk factors for hypokalemia after total hip and knee replacement were the level of preoperative serum potassium (p=0.011), preoperative red blood cells (p=0.027), and a history of diabetes (p=0.007).Conclusion: Regular monitoring of serum potassium should be performed after TJA due to hypokalemia was a very common complication. We need to pay more attention to patients’ preoperative potassium and red blood cells, especially patients with diabetes.


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