Thromboembolic and bleeding complications following primary total knee arthroplasty A DANISH NATIONWIDE COHORT STUDY
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Thromboembolic and bleeding complications following primary total knee arthroplasty A DANISH NATIONWIDE COHORT STUDY. / Schelde, A. B.; Petersen, J.; Jensen, T. B.; Gromov, K.; Overgaard, S.; Olesen, J. B.; Jimenez-Solem, E.
In: Journal of Bone and Joint Surgery: British Volume, Vol. 103B, No. 10, 2021, p. 1571-1577.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Thromboembolic and bleeding complications following primary total knee arthroplasty A DANISH NATIONWIDE COHORT STUDY
AU - Schelde, A. B.
AU - Petersen, J.
AU - Jensen, T. B.
AU - Gromov, K.
AU - Overgaard, S.
AU - Olesen, J. B.
AU - Jimenez-Solem, E.
PY - 2021
Y1 - 2021
N2 - AimsThe aim of this study is to compare the effectiveness and safety of thromboprophylactic treatments in patients undergoing primary total knee arthroplasty (TKA).MethodsUsing nationwide medical registries, we identified patients with a primary TKA performed in Denmark between 1 January 2013 and 31 December 2018 who received thromboprophylactic treatment. We examined the 90-day risk of venous thromboembolism (VTE), major bleeding, and all-cause mortality following surgery. We used a Cox regression model to compute hazard ratios (HRs) with 95% confidence intervals (CIs) for each outcome, pairwise comparing treatment with dalteparin or dabigatran with rivaroxaban as the reference. The HRs were both computed using a multivariable and a propensity score matched analysis.ResultsWe identified 27,736 primary TKA patients who received thromboprophylactic treatment (rivaroxaban (n = 18,846); dalteparin (n = 5,767); dabigatran (n = 1,443); tinzaparin (n = 1,372); and enoxaparin (n = 308)). In the adjusted multivariable analysis and compared with rivaroxaban, treatment with dalteparin (HR 0.68 (95% CI 0.49 to 0.92)) or dabigatran (HR 0.31 (95% CI 0.13 to 0.70)) was associated with a decreased risk of VTE. No statistically significant differences were observed for major bleeding or all-cause mortality. The propensity score matched analysis yielded similar results.ConclusionTreatment with dalteparin or dabigatran was associated with a decreased 90-day risk of VTE following primary TKA surgery compared with treatment with rivaroxaban.
AB - AimsThe aim of this study is to compare the effectiveness and safety of thromboprophylactic treatments in patients undergoing primary total knee arthroplasty (TKA).MethodsUsing nationwide medical registries, we identified patients with a primary TKA performed in Denmark between 1 January 2013 and 31 December 2018 who received thromboprophylactic treatment. We examined the 90-day risk of venous thromboembolism (VTE), major bleeding, and all-cause mortality following surgery. We used a Cox regression model to compute hazard ratios (HRs) with 95% confidence intervals (CIs) for each outcome, pairwise comparing treatment with dalteparin or dabigatran with rivaroxaban as the reference. The HRs were both computed using a multivariable and a propensity score matched analysis.ResultsWe identified 27,736 primary TKA patients who received thromboprophylactic treatment (rivaroxaban (n = 18,846); dalteparin (n = 5,767); dabigatran (n = 1,443); tinzaparin (n = 1,372); and enoxaparin (n = 308)). In the adjusted multivariable analysis and compared with rivaroxaban, treatment with dalteparin (HR 0.68 (95% CI 0.49 to 0.92)) or dabigatran (HR 0.31 (95% CI 0.13 to 0.70)) was associated with a decreased risk of VTE. No statistically significant differences were observed for major bleeding or all-cause mortality. The propensity score matched analysis yielded similar results.ConclusionTreatment with dalteparin or dabigatran was associated with a decreased 90-day risk of VTE following primary TKA surgery compared with treatment with rivaroxaban.
KW - VENOUS THROMBOEMBOLISM
KW - THROMBOPROPHYLAXIS
KW - HIP
KW - ENOXAPARIN
KW - APIXABAN
KW - RIVAROXABAN
KW - ADVANCE-2
KW - SYSTEM
KW - DEATH
U2 - 10.1302/0301-620X.103B10.BJJ-2021-0023.R1
DO - 10.1302/0301-620X.103B10.BJJ-2021-0023.R1
M3 - Journal article
C2 - 34587805
VL - 103B
SP - 1571
EP - 1577
JO - Journal of Bone and Joint Surgery: British Volume
JF - Journal of Bone and Joint Surgery: British Volume
SN - 2049-4394
IS - 10
ER -
ID: 281981935