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THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

V Dzupa, Z Motovska, P Widimsky

    Bratislavske Lekarske Listy
    |January 28, 2017
    PubMed

    Insights

    Patients with cardiac disease undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) face a higher risk of bleeding complications. These complications are more frequent after THA and TKA compared to other surgeries, even after adjusting for risk factors.

    Area of Science:

    • Orthopedic Surgery
    • Cardiology
    • Thromboembolic Disease Management

    Background:

    • Patients with cardiac disease have complex perioperative needs.
    • Thromboembolic disease poses significant risks in surgical patients.
    • Understanding complication rates after major joint replacement is crucial for patient safety.

    Purpose of the Study:

    • To determine the incidence of bleeding and ischemic complications.
    • To compare complication rates after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in cardiac patients.
    • To evaluate complication risks relative to other musculoskeletal surgeries.

    Main Methods:

    • Retrospective study of 477 patients with cardiac disease undergoing THA or TKA between 2010-2013.
    • All patients received perioperative prevention of thromboembolic disease with low-molecular-weight heparins.
    • Data collection focused on perioperative bleeding and ischemic complications.

    Main Results:

    • Overall complication rate was 11.6% (55/477 patients).
    • Bleeding complications occurred in 32 patients, ischemic in 19.
    • Bleeding complications were significantly more frequent after THA/TKA compared to other surgeries (p=0.003).

    Conclusions:

    • Patients with cardiac disease undergoing THA and TKA have a significantly higher incidence of bleeding complications.
    • The risk of bleeding complications after THA/TKA is elevated compared to other musculoskeletal surgeries.
    • Bleeding complications after these procedures may not be easily predictable.

    Keywords:
    ischaemic complicationsperioperative bleedingtotal hip replacement total knee replacement.

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