Upper gastrointestinal bleeding after hip and knee arthroplasty.

Area of Science:

• Orthopedic Surgery
• Gastroenterology
• Pharmacology

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants are frequently used medications.
• These medications are known risk factors for upper gastrointestinal bleeding (UGIB).
• Patients undergoing major orthopedic procedures like hip and knee arthroplasty often receive these drugs perioperatively.

Purpose of the Study:

• To assess the incidence of upper gastrointestinal bleeding (UGIB) in patients undergoing hip and knee arthroplasty.
• To evaluate the complication rate in patients receiving both NSAIDs and anticoagulants.
• To determine if the incidence of UGIB is underestimated in this patient population.

Main Methods:

• A single-center, retrospective study design.
• Inclusion of 100 consecutive hip arthroplasties and 100 consecutive knee arthroplasties.
• Data collection on patient demographics, medication use (NSAIDs, anticoagulants), and postoperative complications.

Main Results:

• The study included 200 patients (63% female, mean age 74).
• Fifty-four percent of patients received NSAIDs, and 100% received anticoagulants perioperatively.
• A postoperative upper gastrointestinal bleeding (UGIB) incidence of 4.5% was observed.

Conclusions:

• The incidence of upper gastrointestinal bleeding (UGIB) as a complication following hip and knee arthroplasty may be underestimated.
• Perioperative use of NSAIDs in conjunction with anticoagulants poses a significant risk.
• Gastro-protective agents should be considered for patients on NSAIDs during the perioperative period to mitigate UGIB risk.