Effectiveness of apixaban versus enoxaparin in preventing wound complications and deep venous thrombosis following total knee replacement surgery: A retrospective study

Hasan, Mohannad Ali; Al-Saadi, Malath Azeez; Mehsen, Jameel Tahseen

doi:10.1111/ijcp.14552

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…API, an oral antithrombotic preparation, comparable to enoxaparin is suitable for both knee replacement and HA patients, effectively reducing the incidence of DVT and the risk of postoperative bleeding [19,20] . Enoxaparin, is a kind of LMWH that can only be administered subcutaneously, can inhibit FXa by binding to antithrombin, thus playing an antithrombotic role [21] .…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Apixaban vs. Low Molecular Weight Heparin in Hip Arthroplasty and their Influence on Coagulation Function and Postoperative Deep Vein Thrombosis

Kaken,

Wang,

Taximaimaiti

et al. 2024

IJPS

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This research compared the efficacy of apixaban and low molecular weight heparin in patients undergoing hip arthroplasty and their influence on coagulation function and postoperative deep vein thrombosis. We enrolled 114 patients undergoing hip arthroplasty and assigned them into control group (n=50) and research group (n=64) treated with low molecular weight heparin and apixaban, respectively. The coagulation function which included platelets, prothrombin time, activated partial thromboplastin time, incidence of postoperative deep vein thrombosis, levels of deep vein thrombosis and their associated serum markers like c-reactive protein, d-dimer, homocysteine, and their safety were evaluated and compared between the two groups. The results showed no significant differences in pre-and post-treatment platelets, prothrombin time, activated partial thromboplastin time between research group and control group. The research group was observed with statistically lower postoperative deep vein thrombosis and overall complication rates, as well as lower c-reactive protein, d-dimer and homocysteine levels compared before and after treatment. The results show that although apixaban has no significant effect on blood coagulation in patients undergoing hip arthroplasty. It can effectively prevent postoperative deep vein thrombosis while significantly inhibiting c-reactive protein, d-dimer and homocysteine with fewer adverse reactions.

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Section: Resultsmentioning

confidence: 99%

Efficacy of Apixaban vs. Low Molecular Weight Heparin in Hip Arthroplasty and their Influence on Coagulation Function and Postoperative Deep Vein Thrombosis

Kaken,

Wang,

Taximaimaiti

et al. 2024

IJPS

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show abstract

“…In this study, advanced age was found to be a risk factor for lower extremity DVT after total knee arthroplasty. It has been shown [ 18 , 19 ] that elderly patients have degenerative changes in vascular elasticity due to the decline in blood circulation function, leading to a subsequent decrease in the body ability to dissolve fibrin, slowing down or even stagnation of blood flow, which is thought to be closely related to the occurrence of DVT. Therefore, increased attention should be paid to elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a predictive model for lower extremity deep vein thrombosis after total knee arthroplasty

Peng

2024

Medicine

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The aim was to investigate the independent risk factors for lower extremity deep vein thrombosis (DVT) after total knee arthroplasty, and to establish a nomogram prediction model accordingly. Data were collected from total knee replacement patients from January 2022 to December 2023 in our hospital. Unifactorial and multifactorial logistic regression analyses were used to determine the independent risk factors for lower extremity DVT after total knee arthroplasty and to establish the corresponding nomogram. The receiver operating characteristic curves were plotted and the area under the curve was calculated, and the calibration curves and decision curves were plotted to evaluate the model performance. A total of 652 patients with total knee arthroplasty were included in the study, and 142 patients after total knee arthroplasty developed deep veins in the lower extremities, with an incidence rate of 21.78%. After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for lower extremity DVT after total knee arthroplasty: age > 60 years (OR: 1.70; 95% CI: 1.23–3.91), obesity (OR: 1.51; 95% CI: 1.10–1.96), diabetes mellitus (OR: 1.80; 95% CI: 1.23–2.46), D-dimer > 0.5 mg/L (OR: 1.47; 95% CI: 1.07–1.78), and prolonged postoperative bed rest (OR: 1.64; 95% CI: 1.15–3.44). the nomogram constructed in this study for lower extremity DVT after total knee arthroplasty has good predictive accuracy, which helps physicians to intervene in advance in patients at high risk of lower extremity DVT after total knee arthroplasty.

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Outcomes of different perioperative management strategies of patients on chronic anticoagulation in elective total hip and knee arthroplasty: a systematic review

Andronic,

Ammann

et al. 2024

Family Practice

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Introduction There are currently different management guidelines for patients undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) that are on long-term anticoagulation. The timing of discontinuation and restarting the anticoagulation is challenging during the postoperative care, which often involves general practitioners and physiotherapists. Methods The systematic review followed the PRISMA guidelines and included 3 databases: PubMed/MEDLINE, EMBASE, and Web of Science Core Collection. It was registered in the International Prospective Register for Systematic Reviews and Meta-analysis (PROSPERO) under the registration number: CRD42023408906. The risk of bias assessment was performed using the Methodological index for non-randomized studies (MINORS) criteria. Results Six retrospective studies involving 727 patients with therapeutic anticoagulation (1,540 controls) for elective THA, TKA and revision arthroplasty have been included. The follow-up ranged from 30 days to 1 year postoperatively. All studies evaluated outcomes of warfarin therapeutic anticoagulation versus prophylactic dosages of one or more of the following: warfarin, aspirin, low-molecular-weight heparin (LMWH) and unfractionated low-dose heparin (UFH). One study did not discontinue therapeutic anticoagulation. Two studies reported no significant differences in complications between groups, whilst 3 studies had significantly higher rates of superficial wound infections, revision surgeries, postoperative haematomas, and prosthetic joint infections (PJI). Conclusion Different anticoagulation-related perioperative management strategies achieve different outcomes following elective arthroplasty in patients with therapeutic chronic anticoagulation. There is contradictory evidence regarding the need for the discontinuation of therapeutic warfarin. Retrospective data showed that individual risk stratification with multi-modal prophylaxis resulted in minimal complications. Level of Evidence Systematic Review of Level III studies.

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Effectiveness of apixaban versus enoxaparin in preventing wound complications and deep venous thrombosis following total knee replacement surgery: A retrospective study

Cited by 3 publications

References 17 publications

Efficacy of Apixaban vs. Low Molecular Weight Heparin in Hip Arthroplasty and their Influence on Coagulation Function and Postoperative Deep Vein Thrombosis

Efficacy of Apixaban vs. Low Molecular Weight Heparin in Hip Arthroplasty and their Influence on Coagulation Function and Postoperative Deep Vein Thrombosis

Construction and validation of a predictive model for lower extremity deep vein thrombosis after total knee arthroplasty

Outcomes of different perioperative management strategies of patients on chronic anticoagulation in elective total hip and knee arthroplasty: a systematic review

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