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...

Full description

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)
id EDOCUR2_058d03191692b018b8625d2d2455fc47
oai_identifier_str oai:repository.urosario.edu.co:10336/22238
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.spa.fl_str_mv Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
title Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
spellingShingle Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
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
title_short Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
title_full Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
title_fullStr Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
title_full_unstemmed Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
title_sort Primary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort Study
dc.subject.keyword.spa.fl_str_mv 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
topic 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
dc.subject.keyword.eng.fl_str_mv replacement
replacement
knee
hip
Arthroplasty
Arthroplasty
description 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.
publishDate 2016
dc.date.created.spa.fl_str_mv 2016
dc.date.accessioned.none.fl_str_mv 2020-05-25T23:55:51Z
dc.date.available.none.fl_str_mv 2020-05-25T23:55:51Z
dc.type.eng.fl_str_mv article
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.spa.spa.fl_str_mv Artículo
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1016/j.arth.2016.03.025
dc.identifier.issn.none.fl_str_mv 08835403
15328406
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/22238
url https://doi.org/10.1016/j.arth.2016.03.025
https://repository.urosario.edu.co/handle/10336/22238
identifier_str_mv 08835403
15328406
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.citationEndPage.none.fl_str_mv 2268
dc.relation.citationIssue.none.fl_str_mv No. 10
dc.relation.citationStartPage.none.fl_str_mv 2264
dc.relation.citationTitle.none.fl_str_mv Journal of Arthroplasty
dc.relation.citationVolume.none.fl_str_mv Vol. 31
dc.relation.ispartof.spa.fl_str_mv Journal of Arthroplasty, ISSN:08835403, 15328406, Vol.31, No.10 (2016); pp. 2264-2268
dc.relation.uri.spa.fl_str_mv https://www.scopus.com/inward/record.uri?eid=2-s2.0-84975744157&doi=10.1016%2fj.arth.2016.03.025&partnerID=40&md5=df4196f7619ccd2730381b4042433327
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.spa.fl_str_mv Abierto (Texto Completo)
rights_invalid_str_mv Abierto (Texto Completo)
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Churchill Livingstone Inc.
institution Universidad del Rosario
dc.source.instname.spa.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.spa.fl_str_mv reponame:Repositorio Institucional EdocUR
bitstream.url.fl_str_mv https://repository.urosario.edu.co/bitstreams/deb9d993-9833-480e-b14b-c49ef6f15bad/download
https://repository.urosario.edu.co/bitstreams/94a55d13-7c64-4ff5-a6a3-170752a1b50c/download
https://repository.urosario.edu.co/bitstreams/8316e4dd-73e5-4fe7-baff-cb6b4369d92b/download
bitstream.checksum.fl_str_mv bf21d05159812ea18a85aea7098ef784
8d393d70efa258e26ccf00ce293ece82
08eb5454e59b2fa8dd13a2f17b2cdac5
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositorio institucional EdocUR
repository.mail.fl_str_mv edocur@urosario.edu.co
_version_ 1814167579517779968
spelling f5a526a6-7fd0-40b9-8591-b56acaf5d6be-1d66b03dd-5167-4688-8a77-d37418b0bb4c-12f0e07a5-e325-42c2-8f46-1bf7713f5e5c-1b658c668-c5a9-4afc-8f4f-e246b433db1e-180307d97-9a3e-4dad-a2ee-d6e348c24101-13e54570f-6684-49b1-9c54-b7e66a66dfff-11b0ce19e-e5db-4e0f-a068-60e00513f295-12020-05-25T23:55:51Z2020-05-25T23:55:51Z2016Background 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.application/pdfhttps://doi.org/10.1016/j.arth.2016.03.0250883540315328406https://repository.urosario.edu.co/handle/10336/22238engChurchill Livingstone Inc.2268No. 102264Journal of ArthroplastyVol. 31Journal of Arthroplasty, ISSN:08835403, 15328406, Vol.31, No.10 (2016); pp. 2264-2268https://www.scopus.com/inward/record.uri?eid=2-s2.0-84975744157&doi=10.1016%2fj.arth.2016.03.025&partnerID=40&md5=df4196f7619ccd2730381b4042433327Abierto (Texto Completo)http://purl.org/coar/access_right/c_abf2instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURDabigatranFondaparinuxLow molecular weight heparinRivaroxabanAnticoagulant agentAgedArticleCohort analysisControlled studyFemaleHigh risk patientHip arthroplastyHip diseaseHumanKnee diseaseMajor clinical studyMajor surgeryMaleOutcome assessmentPatient safetyPostoperative hemorrhageRetrospective studyRisk assessmentSurgical patientSurgical riskTotal knee arthroplastyTreatment responseAdverse effectsAgeBlood transfusionChemically inducedColombiaComparative studyHemorrhageHip replacementKnee replacementMiddle agedOrthopedic surgeryPostoperative complicationsRisk factorVenous thromboembolismVery elderlyAge factorsAgedAged, 80 and overAnticoagulantsBlood transfusionColombiaFemaleHemorrhageHumansMaleMiddle agedOrthopedic proceduresPostoperative complicationsRetrospective studiesRisk factorsVenous thromboembolismAgedAnticoagulantsArthroplastyHipKneePostoperative hemorrhagereplacementreplacementkneehipArthroplastyArthroplastyPrimary Joint Arthroplasty Surgery: Is the Risk of Major Bleeding Higher in Elderly Patients? A Retrospective Cohort StudyarticleArtículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Quintero, Jorge I.Cárdenas, Laura L.Navas, MónicaBautista, Maria P.Bonilla, Guillermo A.Llinás, Adolfo M.Surgery, Clinical Care Program in Joint ReplacementORIGINAL1-s2-0-S0883540316003004-main.pdfapplication/pdf365741https://repository.urosario.edu.co/bitstreams/deb9d993-9833-480e-b14b-c49ef6f15bad/downloadbf21d05159812ea18a85aea7098ef784MD51TEXT1-s2-0-S0883540316003004-main.pdf.txt1-s2-0-S0883540316003004-main.pdf.txtExtracted texttext/plain26408https://repository.urosario.edu.co/bitstreams/94a55d13-7c64-4ff5-a6a3-170752a1b50c/download8d393d70efa258e26ccf00ce293ece82MD52THUMBNAIL1-s2-0-S0883540316003004-main.pdf.jpg1-s2-0-S0883540316003004-main.pdf.jpgGenerated Thumbnailimage/jpeg4594https://repository.urosario.edu.co/bitstreams/8316e4dd-73e5-4fe7-baff-cb6b4369d92b/download08eb5454e59b2fa8dd13a2f17b2cdac5MD5310336/22238oai:repository.urosario.edu.co:10336/222382022-05-02 07:37:20.315276https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.co