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Upper gastrointestinal bleeding after hip and knee arthroplasty

Sunil Sharma1

  • 1Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom.

Orthopedics
|March 17, 2006
PubMed

Insights

Upper gastrointestinal bleeding is a risk for patients on nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants. This study found a 4.5% incidence in hip and knee arthroplasty patients, suggesting it may be underestimated.

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.

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