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:6/26/2016)... Carolina (PRWEB) , ... June 26, 2016 , ... ... of a new product that was developed to enhance the health of felines. The ... centuries. , The two main herbs in the PawPaws Cat Kidney Support ...
(Date:6/25/2016)... ... 2016 , ... Experts from the American Institutes for Research ... June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR experts ... planning, healthcare costs and patient and family engagement. , AIR researchers will be ...
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture animations, FCPX ... Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package transforms over ... Cut Pro X . Simply select a ProHand generator and drag it above media ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. Calvin Johnson has ... he has implemented orthobiologic procedures as a method for treating his patients. The ... first doctors to perform the treatment. Orthobiologics are substances that orthopaedic surgeons use ...
(Date:6/24/2016)... ... , ... A recent article published June 14 on E Online ... on to state that individuals are now more comfortable seeking to undergo not only ... calf and cheek reduction. The Los Angeles area medical group, Beverly Hills Physicians (BHP) ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 ... has announced the addition of the " Global ... This report ... provides an updated review, including its applications in various ... total market, which includes three main industries: pharmaceutical and ...
(Date:6/24/2016)... and SAN CLEMENTE, Calif. , June ... -based mobile pulmonary function testing company, is now able to ... devices developed by ndd Medical Technologies , Inc. ... done in hospital-based labs.  Thanks to ndd,s EasyOne PRO ® , ... , can get any needed testing done in the comfort of ...
(Date:6/24/2016)... , June 24, 2016 ... appointment of Dr. Edward Futcher to ... Director, effective June 23, 2016.Dr. Futcher was also ... and Governance Committees.  As a non-executive member of ... expertise and strategic counsel to VolitionRx in connection ...
Breaking Medicine Technology: