Navigation Links
Are blood thinners post-op killers?

Current US guidelines for the prescription of potent anticoagulants by surgeons who perform joint replacement operations could be doing patients more harm than good, according to Dr. Nigel Sharrock and his team from the Hospital for Special Surgery in New York. They argue for a revision of the American College of Chest Physicians guidelines, in light of their review showing that the use of powerful anticoagulants to prevent pulmonary embolism may actually lead to more deaths among patients who take these drugs. The paper (1) was published in the March issue of Springers journal Clinical Orthopaedics and Related Research.

Anticoagulants are routinely prescribed before and after total hip and knee replacement operations to reduce the risk of thrombosis, and death from pulmonary embolism in particular, as recommended by the Chest Physicians Consensus Statement. During the last decades, deaths from pulmonary embolism have fallen significantly due to a combination of advancements in anesthesia, better surgical techniques and care pre- and post-surgery, as well as a better understanding of how thrombosis develops as a result of surgery. In light of these developments, Sharrock and his team looked at whether the prescription of potent anticoagulants by surgeons who perform joint replacement operations is still warranted, as these drugs also have side effects.

The authors reviewed 20 studies among a total of just over 28,000 patients undergoing joint replacement surgery who were prescribed medication to reduce the risk of thrombosis. They compared the total number of deaths and cases of non-fatal pulmonary embolism between three frequently used prevention protocols worldwide. Patients in group A received potent anticoagulants such as low molecular weight heparin; those in group B received local spinal or epidural anesthesia, pneumatic compression and aspirin; patients in group C were prescribed slow-acting oral anticoagulants such as warfarin.

The lowest number of deaths occurred in patients in group B. Patients in groups A and C were more than twice as likely to have died as those in group B. There was no difference in the number of deaths between groups A and C. Patients in group A were also at 60-70% greater risk of non-fatal pulmonary embolism than those in group B, indicating that pulmonary embolism occurs despite the use of powerful anticoagulants.

Sharrock and colleagues conclude that the American College of Chest Physicians should reconsider their guidelines to reflect the fact that pulmonary embolism occurs despite the use of potent anticoagulants and may, in fact, expose patients to increased mortality after surgery. In their view, the current recommendations often result in physicians feeling compelled to prescribe these anticoagulants to avoid potential litigation when, in reality, these drugs could be doing more harm than good.


Contact: Joan Robinson

Related medicine news :

1. Stem cells from hair follicles may help grow new blood vessels
2. BioLife Solutions Expands Presence in Cell Therapy and Cord Blood Banking Market Segments
3. ISBT 128 Labeling Implementation Date Looms for Blood Centers
4. Basis created for directing and filming blood vessels
5. Fear that freezes the blood in your veins
6. Spit tests may soon replace many blood tests
7. NY-Area Paramedic Wins 2007 Francis X. Hursey Award for Heroic Use of QuikClot(R) Blood Clotting Product
8. High Blood Pressure Runs in Families
9. ABC and NMDP Partner to Meet Growing Need for Stem Cell and Cord Blood Transplants, Assure Funding for Cord Blood Network, Encourage Minority Donor Recruitment
10. Transfusions of Older Blood Dont Work as Well
11. Haemonetics(R) Software Solutions to Launch Application for Workflow Optimization in Blood Collection Centers
Post Your Comments:
(Date:10/13/2017)... ... October 13, 2017 , ... The American Board of Family ... next President and Chief Executive Officer, succeeding Dr. James C. Puffer upon his retirement. ... 1, 2018 until Dr. Puffer’s retirement at the end of 2018. Upon assuming the ...
(Date:10/13/2017)... ... , ... Apple Rehab Shelton Lakes , which specializes in the delivery ... as part of a disaster drill on October 3rd. , Apple Rehab participated with ... Manager, as well as the Connecticut Long Term Care Mutual Aid Plan (LTC-MAP). ...
(Date:10/13/2017)... ... 2017 , ... Yisrayl Hawkins, Pastor and Overseer at The House of Yahweh, ... and least understood books in the Holy Scriptures, Revelation. The Book of Revelation paints ... for centuries. Many have tossed it off as mere rubbish, but Yisrayl Hawkins says ...
(Date:10/12/2017)... ... 12, 2017 , ... First Healthcare Compliance (FHC), an industry ... a range of technology and learning solutions at the 68th Annual American Healthcare ... be held October 14–18, 2017 at the Mandalay Bay Resort in Las Vegas, ...
(Date:10/12/2017)... MD (PRWEB) , ... October 12, 2017 , ... The ... of Excellence to Carol Friedman, PhD, FACMI, during the Opening Session of AMIA’s Annual ... – 8. , In honor of Morris F. Collen, a pioneer in the field ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... COPENHAGEN, Denmark , Oct. 2, 2017 The ... tool in the struggle to reverse the tide of prescription ... plan for regulating their medicine intake and stepping down their ... is set to launch in December 2017; the first 100,000 ... access. Learn more at ...
(Date:9/27/2017)... and NEW YORK , Sept. 27, 2017 ... mobile health and big data solutions, today announced that its MyDario product ... check your local TV listings for when The Dr. Oz Show airs ... The ... this month. ...
(Date:9/22/2017)... ROCKVILLE, Md. , Sept. 22, 2017  As ... by Republican Senators Bill Cassidy (R-LA) and ... Kalorama Information notes that the medical device industry is ... the medical device tax, the 2.3% excise tax on ... Act.  But they also want covered patients, increased visits ...
Breaking Medicine Technology: