Complications of anticoagulation for thromboembolism in early postoperative total joint arthroplasty

In the study reported here, we analyzed the complications associated with anticoagulation in total joint arthroplasty patients treated for venous thromboembolism (VTE) in the early postoperative period. Twenty-nine consecutive cases from a 1-year period were identified and retrospectively reviewed. VTE treatment, which in most instances (79%) consisted of a heparin drip, was begun a mean of 2.3 days after surgery. Patients received a mean (SD) of 4.4 (5.0) units of packed red blood cells. There were no differences in bleeding parameters with respect to timing of initiation of anticoagulation. Local and systemic bleeding complications were common. The proportion of patients who were transfused was significantly (P<.0001) higher for VTE patients than for control patients, and transfused VTE patients received significantly (P = .0004) more blood products. In total joint arthroplasty patients, VTE treatment began 2.3 days after surgery and had a high incidence of complications related to bleeding.