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Clinical Orthopaedics and Related Research®

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01-03-2008 | Original Article

Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty

Authors: Nigel E. Sharrock, BMedSci, MB, ChB, Alejandro Gonzalez Della Valle, MD, George Go, BS, Stephen Lyman, PhD, Eduardo A. Salvati, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2008

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.

Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Title: Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty
Authors: Nigel E. Sharrock, BMedSci, MB, ChB
Alejandro Gonzalez Della Valle, MD
George Go, BS
Stephen Lyman, PhD
Eduardo A. Salvati, MD
Publication date: 01-03-2008
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 3/2008
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-007-0092-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty

Abstract

Keynote webinar | Spotlight on medication adherence

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Abstract

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