Low-Molecular-Weight Heparin and the Relative Risk of Surgical Site Bleeding Complications: Results of a Systematic Review and Meta-Analysis of Randomized Controlled Trials of Venous Thromboprophylaxis in Patients After Total Joint Arthroplasty

The Journal of Arthroplasty
Kary SuenAndrew J Hardidge

Abstract

Venous thromboembolism causes significant morbidity and mortality in patients after total joint arthroplasty. Although network meta-analyses have demonstrated a benefit of various thromboprophylactic agents, there remains a concern in the surgical community regarding the resulting wound complications. There is currently no systematic review of the surgical site bleeding complications of thromboprophylactic agents. The aim of this study was to systematically review the surgical site bleeding outcomes of venous thromboembolism prophylaxis in this population. A systematic review and meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials comparing more than one of low-molecular-weight heparin (LMWH), warfarin, rivaroxaban, apixaban, dabigatran, aspirin, or no pharmacologic treatment in patients after total hip or knee arthroplasty were selected for inclusion. Five meta-analyses were performed to compare LMWH with control, warfarin, apixaban, rivaroxaban, and dabigatran. Forty-five randomized controlled trials of 56,730 patients were included. LMWH had a significantly increased relative risk of surgical site bleeding in comparison with control...Continue Reading

Citations

Aug 1, 2019·Journal of the American Heart Association·George NtaiosPatrik Michel
Oct 4, 2019·International Angiology : a Journal of the International Union of Angiology·Kurt G SeagraveKerry Hitos
Jun 7, 2020·Archives of Orthopaedic and Trauma Surgery·Jessica H HeyerAndrew S Neviaser
May 14, 2021·The Journal of Bone and Joint Surgery. American Volume·Arjun K ReddyMatt Vassar
Apr 10, 2020·ACS Applied Materials & Interfaces·Ryan DevineHitesh Handa

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