Title |
Potent Anticoagulants are Associated with a Higher All‐Cause Mortality Rate After Hip and Knee Arthroplasty
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Published in |
Clinical Orthopaedics & Related Research, February 2008
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DOI | 10.1007/s11999-007-0092-4 |
Pubmed ID | |
Authors |
Nigel E. Sharrock, Alejandro Gonzalez Della Valle, George Go, Stephen Lyman, Eduardo A. Salvati |
Abstract |
Anticoagulation for thromboprophylaxis after THA and TKA has not been confirmed to diminish all-cause mortality. We determined whether the incidence of all-cause mortality and pulmonary embolism in patients undergoing total joint arthroplasty differs with currently used thromboprophylaxis protocols. We reviewed articles published from 1998 to 2007 that included 6-week or 3-month incidence of all-cause mortality and symptomatic, nonfatal pulmonary embolism. Twenty studies included reported 15,839 patients receiving low-molecular-weight heparin, ximelagatran, fondaparinux, or rivaroxaban (Group A); 7193 receiving regional anesthesia, pneumatic compression, and aspirin (Group B); and 5006 receiving warfarin (Group C). All-cause mortality was higher in Group A than in Group B (0.41% versus 0.19%) and the incidence of clinical nonfatal pulmonary embolus was higher in Group A than in Group B (0.60% versus 0.35%). The incidences of all-cause mortality and nonfatal pulmonary embolism in Group C were similar to those in Group A (0.4 and 0.52, respectively). Clinical pulmonary embolus occurs despite the use of anticoagulants. Group A anticoagulants were associated with the highest all-cause mortality of the three modalities studied. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 50% |
Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Korea, Republic of | 1 | <1% |
South Africa | 1 | <1% |
Ukraine | 1 | <1% |
Canada | 1 | <1% |
Slovenia | 1 | <1% |
United States | 1 | <1% |
Unknown | 114 | 95% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 22 | 18% |
Researcher | 15 | 13% |
Student > Bachelor | 12 | 10% |
Professor > Associate Professor | 10 | 8% |
Student > Ph. D. Student | 8 | 7% |
Other | 38 | 32% |
Unknown | 15 | 13% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 83 | 69% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 3% |
Agricultural and Biological Sciences | 2 | 2% |
Nursing and Health Professions | 2 | 2% |
Unspecified | 2 | 2% |
Other | 5 | 4% |
Unknown | 23 | 19% |