Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
Background Increased risk of bleeding after major orthopedic surgery (MOS) has been widely documented in general population. However, this complication has not been studied in elderly patients. The purpose of this study is to determine whether the risk of major bleeding after MOS is higher in elderl...
- Autores:
- Tipo de recurso:
- Fecha de publicación:
- 2016
- Institución:
- Universidad del Rosario
- Repositorio:
- Repositorio EdocUR - U. Rosario
- Idioma:
- eng
- OAI Identifier:
- oai:repository.urosario.edu.co:10336/22238
- Acceso en línea:
- https://doi.org/10.1016/j.arth.2016.03.025
https://repository.urosario.edu.co/handle/10336/22238
- Palabra clave:
- Dabigatran
Fondaparinux
Low molecular weight heparin
Rivaroxaban
Anticoagulant agent
Aged
Article
Cohort analysis
Controlled study
Female
High risk patient
Hip arthroplasty
Hip disease
Human
Knee disease
Major clinical study
Major surgery
Male
Outcome assessment
Patient safety
Postoperative hemorrhage
Retrospective study
Risk assessment
Surgical patient
Surgical risk
Total knee arthroplasty
Treatment response
Adverse effects
Age
Blood transfusion
Chemically induced
Colombia
Comparative study
Hemorrhage
Hip replacement
Knee replacement
Middle aged
Orthopedic surgery
Postoperative complications
Risk factor
Venous thromboembolism
Very elderly
Age factors
Aged
Aged, 80 and over
Anticoagulants
Blood transfusion
Colombia
Female
Hemorrhage
Humans
Male
Middle aged
Orthopedic procedures
Postoperative complications
Retrospective studies
Risk factors
Venous thromboembolism
Aged
Anticoagulants
Arthroplasty
Hip
Knee
Postoperative hemorrhage
replacement
replacement
knee
hip
Arthroplasty
Arthroplasty
- Rights
- License
- Abierto (Texto Completo)
Summary: | Background Increased risk of bleeding after major orthopedic surgery (MOS) has been widely documented in general population. However, this complication has not been studied in elderly patients. The purpose of this study is to determine whether the risk of major bleeding after MOS is higher in elderly patients, compared with those operated at a younger age. Methods This retrospective cohort study included total hip and total knee arthroplasty patients operated during 5 consecutive years. The main outcome was the occurrence of major bleeding. Patients with other causes of bleeding were excluded. Relative risks (RRs) and confidence intervals (CIs) were calculated, and a multivariate analysis was performed. Results A total of 1048 patients were included, 56% of patients were hip arthroplasties. At the time of surgery, 553 (53%) patients were older than 70 years. Patients aged >70 years showed an increased risk of major bleeding (RR: 2.42 [95% CI: 1.54-3.81]). For hip arthroplasty, the RR of bleeding was 2.61 (95%CI: 1.50-4.53) and 2.25 (95% CI: 1.03-4.94) for knee arthroplasty. After multivariate analysis, age was found to be independently associated with higher risk of major bleeding. Conclusion According to European Medicines Agency criteria, patients aged ?70 years are at a higher risk of major bleeding after MOS, result of a higher frequency of blood transfusions in this group of patients. Standardized protocols for blood transfusion in these patients are still required. © 2016 Elsevier Inc. |
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