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Association between duration of anticoagulant thromboprophylaxis and revision rate in primary total hip arthroplasty: a Danish and Norwegian nationwide cohort study.

Authors :
VINTHER, Dennis
MAILHAC, Aurelie
ANDERSEN, Ina Trolle
OVERGAARD, Søren
LIE, Stein Atle
FENSTAD, Anne Marie
GJERTSEN, Jan-Erik
FURNES, Ove
PEDERSEN, and Alma B.
Source :
Acta Orthopaedica; 2022, Vol. 93, p930-937, 8p
Publication Year :
2022

Abstract

Background and purpose -- There are concerns that bleeding following primary total hip arthroplasty (THA) contributes to prolonged wound drainage and prosthetic joint infection (PJI). We examined whether short (1--5 days), medium (6--14 days), and extended (≥ 15 days) duration of thromboprophylaxis is associated with the 5-year revision rate after THA due to osteoarthritis. Patients and methods -- We performed a cohort study based on data from hip arthroplasty and administrative registries in Denmark and Norway (2008--2014). The outcome was revision surgery due to PJI, aseptic loosening or any cause, and patient mortality. Adjusted cause-specific hazard ratios (HRs) were analyzed with Cox regression analyses. Results -- Among 50,482 THA patients, 8,333 received short, 17,009 received medium, and 25,140 received extended thromboprophylaxis. The HRs for revision due to PJI within 5 years were 1.0 (95%CI 0.7--1.3) and 1.1 (CI 0.9--1.3) for short and extended vs. medium treatment, whereas HR for extended vs. medium prophylaxis was 1.5 (CI 1.2--2.0) within 3 months. The HRs for revision due to aseptic loosening within 5 years were 1.0 (CI 0.7--1.4) and 1.1 (CI 0.9--1.4) for short and extended vs. medium treatment. The HRs for any revision within 5 years were 0.9 (CI 0.8--1.1) and 0.9 (CI 0.8--1.0) for short and extended vs. medium treatment. Extended vs. medium prophylaxis was associated with a decreased 0--3 month mortality. The absolute differences at 5 years were ≤ 1%. Conclusion -- Our data suggests no association between duration of anticoagulant thromboprophylaxis and revision rate within 5 years of primary THA. The extended thromboprophylaxis might be associated with early increased revision rate due to PJI but also with lower mortality; however, the clinical relevance of this finding requires further research. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
17453674
Volume :
93
Database :
Complementary Index
Journal :
Acta Orthopaedica
Publication Type :
Academic Journal
Accession number :
162614274
Full Text :
https://doi.org/10.2340/17453674.2022.6243