Development of a risk-oriented algorithm for the combined use of hemostatics and anticoagulants to prevent thrombosis and bleeding cases after total arthroplasty of knee or hip joints

Authors

DOI:

https://doi.org/10.3897/rrpharmacology.7.65708

Abstract

Introduction: The goal of our study was to develop a risk-oriented algorithm for the combined use of hemostatics and anticoagulants in patients after total arthroplasty of the knee or hip joints to reduce the risk of thrombohemorrhagic complications.

Materials and methods: We performed a retrospective study (n=253). In group (Gr.) 1, the time interval (TI) between the administration of hemostatic and anticoagulant prophylaxis was ≤17 hours (n=145; 57.31%), and in Gr. 2 – 18-24 hours (n=108; 42.68%). We analyzed the influence of different factors on the development of thrombosis and bleeding cases after the operation.

Results and discussion: Thrombohemorrhagic complications were observed in 27 (10.67%) patients. Thrombosis in Gr. 1 was associated with the use of tranexamic acid, and were recorded 2.2 times more often than in Gr. 2 (p<0.05). The development of thrombosis in Gr. 1 was influenced by: class II obesity, type 2 diabetes mellitus, myocardial infarction, venous pathology, age of patients >75 years, for women – an initially low level of international normalized ratio, and activated partial thromboplastin time (APTT) (p<0.05). The development of bleeding in Gr. 1 was influenced by: age >75 years, among men and women – an increased preoperative level of APTT, for women – a decreased level of fibrinogen and platelets (p<0.05).

Conclusion: To prevent thrombosis and bleeding after arthroplasty of large joints, the TI between the use of hemostatics and anticoagulants should be at least 18 hours, especially in patients with the above risk factors, in particular, when using tranexamic acid and low molecular weight heparins.

Keywords:

anticoagulants, bleeding, coagulogram, comorbidity, endoprosthetics, hemostatics, thrombosis, time interval

Author Contribution

Lilia S. Golovko, Rostov State Medical University

Senior laboratory assistant of the Department of Pharmacology and Clinical Pharmacology

Andrey V. Safronenko, Rostov State Medical University,

Doctor Habil. of Medical Sciences, Head of the Department of Pharmacology and Clinical Pharmacology

Elena V. Gantsgorn, Rostov State Medical University,

PhD in Medical Sciences, Associate Professor, Department of Pharmacology and Clinical Pharmacology

Nataliya V. Sukhorukova, Rostov State Medical University,

PhD in Medical Sciences, Associate Professor, Department of Pharmacology and Clinical Pharmacology

Andrey V. Kapliev, Rostov State Medical University,

PhD in Medical Sciences, Associate Professor, Department of Pharmacology and Clinical Pharmacology

Downloads

Published

31-03-2021

How to Cite

Golovko LS, Safronenko AV, Gantsgorn EV, Sukhorukova NV, Kapliev AV (2021) Development of a risk-oriented algorithm for the combined use of hemostatics and anticoagulants to prevent thrombosis and bleeding cases after total arthroplasty of knee or hip joints. Research Results in Pharmacology 7(1): 65–74. https://doi.org/10.3897/rrpharmacology.7.65708

Issue

Section

Review article

Most read articles by the same author(s)