Postoperative Anaemia Is a Risk Factor for Bleeding-Related Event in Thromboprophylaxis Using Fondaparinux Sodium Injection after Total Knee or Hip Arthroplasty
Postoperative Anaemia Is a Risk Factor for Bleeding-Related Event in Thromboprophylaxis Using Fondaparinux Sodium Injection after Total Knee or Hip Arthroplasty
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DOI：
10.1248/bpb.b19-00447
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发表时间：
2020-02-01
影响因子：
2
通讯作者：
Okuda, Masahiro
中科院分区：
文献类型：
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作者：
Enokiya, Tomoyuki;Hasegawa, Masahiro;Okuda, Masahiro
出血是磺达肝癸钠（FPX）注射预防血栓形成的一种危及生命的副作用。本回顾性研究的目的是评估全膝关节置换术（TKA）或全髋关节置换术（THA）后FPX血栓预防后出血相关事件的风险因素。在一家大学医院接受TKA或THA的成人患者通过皮下注射每天1.5或2.5 mg FPX进行血栓预防。通过倾向评分调整的多变量logistic分析确定出血相关事件的风险因素，并考虑确定的风险因素回顾性进行生存分析。入组了226例接受TKA（n = 62）或THA（n = 164）的患者。术后第1天（POD）贫血被确定为出血相关事件的风险因素（比值比：3.75，95%置信区间：1.02-24.5，p = 0.04）。使用倾向评分匹配选择了226例患者中的80例，该人群中POD 1贫血患者的出血相关事件发生率显著高于无贫血患者（p = 0.0016，Ghen-Breslow-Wilcoxon检验; p = 0.0015，对数秩检验）。这些结果表明，POD 1贫血是TKA或THA后FPX血栓预防后出血相关事件的独立风险因素。
Bleeding is a life-threating side effect of thromboprophylaxis with fondaparinux sodium (FPX) injection. The purpose of this retrospective study was to assess the risk factor for bleeding-related event following thromboprophylaxis with FPX after total knee arthroplasty (TKA) or total hip arthroplasty (THA). Adult patients undergoing TKA or THA at a single university hospital were administered FPX for thromboprophylaxis by subcutaneous injection of 1.5 or 2.5 mg per day. The risk factor for bleeding-related event was identified by propensity score-adjusted multivariate logistic analysis, and survival analysis was performed retrospectively in consideration of the identified risk factors. Two hundred and twenty-six patients who underwent TKA (n = 62) or THA (n = 164) were enrolled. Anaemia on postoperative day (POD) 1 was identified as a risk factor for bleeding-related event (odds ratio: 3.75, 95% confidence interval: 1.02-24.5, p = 0.04). Eighty of 226 patients were selected using a propensity score matching and patients with anaemia on POD1 in this population had a significantly higher incidence of bleeding-related event than those without anaemia (p = 0.0016, Ghen-Breslow-Wilcoxon test; p = 0.0015, log-rank test). These results suggest that anaemia on POD1 is an independent risk factor for bleeding-related event following thromboprophylaxis with FPX after TKA or THA.