Cargando…

Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty

Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent pre...

Descripción completa

Detalles Bibliográficos
Autores principales: Leitner, Lukas, Musser, Ewald, Kastner, Norbert, Friesenbichler, Jörg, Hirzberger, Daniela, Radl, Roman, Leithner, Andreas, Sadoghi, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973234/
https://www.ncbi.nlm.nih.gov/pubmed/27488941
http://dx.doi.org/10.1038/srep30924
_version_ 1782446369760346112
author Leitner, Lukas
Musser, Ewald
Kastner, Norbert
Friesenbichler, Jörg
Hirzberger, Daniela
Radl, Roman
Leithner, Andreas
Sadoghi, Patrick
author_facet Leitner, Lukas
Musser, Ewald
Kastner, Norbert
Friesenbichler, Jörg
Hirzberger, Daniela
Radl, Roman
Leithner, Andreas
Sadoghi, Patrick
author_sort Leitner, Lukas
collection PubMed
description Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time. In a multivariate logistic regression analysis the independent influences of PAT, demographic parameters, ASA score > 2, and duration of the operation on RCC demand following TKA were analyzed. Patients with PAT were significantly older, more often had an ASA > 2 at surgery, needed a higher number of RCCs units and more frequently and had lower perioperative hemoglobin levels. Multivariate logistic regression revealed PAT was an independent predictor for RCC requirement. PAT patients are more likely to require RCC following TKA and should be accurately monitored with respect to postoperative blood loss.
format Online
Article
Text
id pubmed-4973234
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Nature Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-49732342016-08-11 Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty Leitner, Lukas Musser, Ewald Kastner, Norbert Friesenbichler, Jörg Hirzberger, Daniela Radl, Roman Leithner, Andreas Sadoghi, Patrick Sci Rep Article Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time. In a multivariate logistic regression analysis the independent influences of PAT, demographic parameters, ASA score > 2, and duration of the operation on RCC demand following TKA were analyzed. Patients with PAT were significantly older, more often had an ASA > 2 at surgery, needed a higher number of RCCs units and more frequently and had lower perioperative hemoglobin levels. Multivariate logistic regression revealed PAT was an independent predictor for RCC requirement. PAT patients are more likely to require RCC following TKA and should be accurately monitored with respect to postoperative blood loss. Nature Publishing Group 2016-08-04 /pmc/articles/PMC4973234/ /pubmed/27488941 http://dx.doi.org/10.1038/srep30924 Text en Copyright © 2016, The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Leitner, Lukas
Musser, Ewald
Kastner, Norbert
Friesenbichler, Jörg
Hirzberger, Daniela
Radl, Roman
Leithner, Andreas
Sadoghi, Patrick
Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
title Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
title_full Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
title_fullStr Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
title_full_unstemmed Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
title_short Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
title_sort impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973234/
https://www.ncbi.nlm.nih.gov/pubmed/27488941
http://dx.doi.org/10.1038/srep30924
work_keys_str_mv AT leitnerlukas impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT musserewald impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT kastnernorbert impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT friesenbichlerjorg impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT hirzbergerdaniela impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT radlroman impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT leithnerandreas impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty
AT sadoghipatrick impactofpreoperativeantithrombotictherapyonbloodmanagementafterimplantationofprimarytotalkneearthroplasty