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dc.contributor.authorSuen, Kary-
dc.contributor.authorWesth, Roger N-
dc.contributor.authorChurilov, Leonid-
dc.contributor.authorHardidge, Andrew J-
dc.identifier.citationJournal of Arthroplasty 2017; 32(9): 2911-2919.e6en_US
dc.description.abstractBACKGROUND: 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. METHODS: 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. RESULTS: 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 (relative risk, 2.32; 95% confidence interval, 1.40-3.85) and warfarin (1.54; 1.23-1.94). The relative risk of LMWH trended higher than apixaban (1.27; 1.00-1.63) and was similar to rivaroxaban (0.95; 0.74-1.23). Only 1 study reported the risk of surgical site bleeding in LMWH vs dabigatran (5.97; 2.08-17.11). CONCLUSION: LMWH increased the risk of surgical site bleeding compared with control, warfarin. and dabigatran and trended toward an increased risk compared with apixaban. The risk of surgical site bleeding was similar with LMWH and rivaroxaban.en_US
dc.subjectLow-molecular-weight heparinen_US
dc.subjectPostoperative complicationsen_US
dc.subjectSurgical wounden_US
dc.subjectTotal hip arthroplastyen_US
dc.subjectTotal knee arthroplastyen_US
dc.subjectVenous thromboprophylaxisen_US
dc.titleLow-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 arthroplastyen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleJournal of Arthroplastyen_US
dc.identifier.affiliationDepartment of Orthopaedic Surgery, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Statistics and Decision Support, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australiaen_US
dc.type.austinJournal Articleen_US
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.openairecristype Surgery- Surgery- (University of Melbourne)- Florey Institute of Neuroscience and Mental Health- Surgery-
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