Navigation Links
Are blood thinners post-op killers?
Date:3/31/2008

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
joan.robinson@springer.com
49-622-148-78130
Springer
Source:Eurekalert

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:
*Name:
*Comment:
*Email:
(Date:12/7/2016)... , ... December 07, 2016 , ... ... Dallas, Texas, is condemning "scam operations" carried out by unethical locksmith companies and ... scam operations to a halt. According to Texas Premier Locksmith, these fraudulent locksmith ...
(Date:12/7/2016)... Ohio (PRWEB) , ... December 07, 2016 , ... ... in the 2016 BOC Business Brilliance Awards under the Best New Product Launch ... and results achieved through user experience. , BOC Global Events & Training Group ...
(Date:12/7/2016)... ... 07, 2016 , ... “Tomorrow Trump Goes To Washington”: a brief but ... presidency and to America. “Tomorrow Trump Goes To Washington” is the creation of published ... for this country. , Nancy attributes her patriotic nature to her WWII veteran father. ...
(Date:12/7/2016)... (PRWEB) , ... December 07, 2016 , ... ... the fifth annual Business Architecture Innovation Summit in Reston, VA on March 21-22, ... who will share a range of experiences from a cross-section of industries such ...
(Date:12/6/2016)... ... December 06, 2016 , ... ... networks that can be seen on a type of MRI, according to a ... progressive disorder of the central nervous system characterized by tremors or trembling and ...
Breaking Medicine News(10 mins):
(Date:12/6/2016)... bringing their 100% all-natural lice removal service to Brooklyn ... th Street was specifically chosen to make treatment convenient for ... is to ease parents, stress and bring their lives back under ... to class without skipping a beat. The best part is that ... family," Licenders President Adie Horowitz states. ...
(Date:12/6/2016)... LONDON , Dec. 6, 2016 Diabetes ... The diabetes and obesity disease cluster is currently ... (T1DM) and type 2 diabetes mellitus (T2DM), and the ... and quality of products, is attributable to these indications. ... a large market presence, there are a large number ...
(Date:12/6/2016)... , Dec. 6, 2016 Human Vaccines ... in-depth region wise and country wise analysis of ... include manufacturers of human vaccines products, raw material ... to enter the market. The report provides ... vaccines market. Qualitative analysis comprises market dynamics, trends, ...
Breaking Medicine Technology: