Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty
Why the study?
Do potent anticoagulants reduce all-cause mortality and pulmonary embolism compared to regional anesthesia, pneumatic compression, and aspirin in patients undergoing total joint arthroplasty?
Population
28,038 patients undergoing total hip and knee arthroplasty (THA and TKA) from 20 studies
Comparison
Potent anticoagulants including… vs Regional anesthesia, pneumatic compression, and…
Design
Systematic_review
Follow-up
6 weeks or 3 months
Authors
Discussion
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Member takes
Implication
Supports aspirin-based regimens over potent anticoagulants after joint arthroplasty; challenges guideline-endorsed thromboprophylaxis and requires confirmation in RCTs.
Structured PICO
Do potent anticoagulants reduce all-cause mortality and pulmonary embolism compared to regional anesthesia, pneumatic compression, and aspirin in patients undergoing total joint arthroplasty?
P
Population
28,038 patients undergoing total hip and knee arthroplasty (THA and TKA) from 20 studies
I
Intervention
Potent anticoagulants including low-molecular-weight heparin, ximelagatran, fondaparinux, or rivaroxaban (n=15,839), or warfarin (n=5,006)
C
Comparator
Regional anesthesia, pneumatic compression, and aspirin (n=7,193)
O
Outcome
6-week or 3-month incidence of all-cause mortalityhard clinical
Potent anticoagulants for thromboprophylaxis after joint arthroplasty are associated with higher all-cause mortality and nonfatal pulmonary embolism compared to a regimen of regional anesthesia, pneumatic compression, and aspirin.
Cite This Study
Sharrock et al. (2008) studied this question.