دورية أكاديمية
Chronic Anticoagulation is Associated With Increased Risk for Postoperative Complications Following Aseptic Revision Total Hip Arthroplasty.
| العنوان: | Chronic Anticoagulation is Associated With Increased Risk for Postoperative Complications Following Aseptic Revision Total Hip Arthroplasty. |
|---|---|
| المؤلفون: | Heo KY; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia., Goel RK; Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina., Fuqua A; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia., Rieger E; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia., Karzon AL; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia., Ayeni AM; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia., Muffly BT; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York., Erens GA; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia., Premkumar A; Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia. |
| المصدر: | The Journal of arthroplasty [J Arthroplasty] 2024 Jan 17. Date of Electronic Publication: 2024 Jan 17. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New Brunswick, NJ : Taylor and Francis Original Publication: [New York, NY : Churchill Livingstone, c1986- |
| مستخلص: | Background: With an aging global population, the incidence of revision total hip arthroplasty (rTHA) is expected to increase markedly. While patients undergoing primary total hip arthroplasty who require chronic anticoagulation (AC) have been associated with increased postoperative complications, less is known about the impact of chronic AC status on postoperative complications in the rTHA setting. This study sought to compare complication rates following aseptic rTHA between patients who were on chronic AC and those who were not. Methods: A large national database was utilized to retrospectively identify 9,421 patients who underwent aseptic rTHA between 2014 and 2019. Patients were divided into 2 cohorts: 1,790 patients (19.0%) were in the chronic AC cohort (ie, having an AC prescription filled within 6 months prior to and following rTHA), and 7,631 patients (81.0%) were not on chronic AC. Postoperative complications at 90-days and 2-years were compared between cohorts utilizing univariate and multivariate analyses, controlling for sex, age, and comorbidities. Results: At 90-days, chronic AC patients had increased odds of prosthetic joint infections (PJIs) (odds ratio [OR] 3.2, P < .001), surgical site infections (OR 3.6, P < .001), and mechanical prosthetic complications (OR 3.5, P < .001), which included any aseptic loosening, implant dislocation, or broken prosthetic. At 2-years, chronic AC patients had increased odds of PJI (OR 3.3, P < .001) as well as mechanical prosthetic complications (OR 3.2, P < .001). Chronic AC patients were also at increased risk for reoperation within 2 years after initial aseptic rTHA (OR 1.9, P < .001). Conclusions: Patients on chronic AC have significantly higher odds of 90-day and 2-year complications after aseptic rTHA. This includes increased odds of PJI, surgical site infection, and mechanical prosthetic complications. Patients receiving chronic AC who undergo rTHA should be counseled on the risk-benefit ratio of their chronic AC status in a multidisciplinary setting to optimize their postoperative outcomes. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: aseptic revision total hip arthroplasty; chronic anticoagulation; comorbidities; postoperative complications; postoperative risks |
| تواريخ الأحداث: | Date Created: 20240118 Latest Revision: 20240216 |
| رمز التحديث: | 20240217 |
| DOI: | 10.1016/j.arth.2024.01.020 |
| PMID: | 38237877 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1532-8406 |
|---|---|
| DOI: | 10.1016/j.arth.2024.01.020 |