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The clinical impact of edoxaban for the patients with postoperative anemia after total hip arthroplasty

  • Original Article • HIP - ARTHROPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Postoperative anemia is a common complication after total hip arthroplasty (THA). However, the effect of edoxaban on postoperative anemia after THA remains unclear. Here, we retrospectively evaluated the clinical assessment of postoperative anemia and the associated changes of coagulation parameters in patients undergoing thromboprophylaxis with edoxaban compared with fondaparinux as a conventional anticoagulant thromboprophylactic agent after THA.

Methods

One hundred and forty-nine patients who underwent THA from July 2010 to June 2012 were divided into two groups, according to whether they were operated on before or after the approval of edoxaban: the fondaparinux group (Group F: 86 patients) and the edoxaban group (Group E: 63 patients). The frequency of postoperative anemia and blood coagulation values were investigated.

Results

Postoperative anemia developed more frequently in Group E than in Group F after surgery. However, the degree of postoperative anemia showed no significant difference between the groups. Meanwhile, prothrombin time (PT), prothrombin time-international normalized ratio (PT-INR), and activated partial thromboplastin time were markedly higher in patients with edoxaban-associated postoperative anemia, which showed an increased potential to predict the occurrence of postoperative anemia. Additionally, both PT and PT-INR in Group E were also correlated with the volume of estimated blood loss.

Conclusion

The frequency of postoperative anemia was increased in patients treated with edoxaban, compared to fondaparinux, after THA. Edoxaban thromboprophylaxis might, therefore, require more careful monitoring to prevent postoperative anemia. Additionally, particular prolongation of PT and PT-INR induced by edoxaban treatment might predict postoperative anemia.

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Acknowledgements

We thank Yusuke Ookura, Akimasa Yoshida, Kazuma Koga, Yuko Kuwada, Anna Ueno, Satomi Tani, Shunki Ishihara for helpful discussion and assistance with all our data analyses. Repeatedly, all of them helped with the data extraction from their respective database and ensured the high quality of the data by numerous quality checks.

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Authors and Affiliations

  1. Department of Pharmacy, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan

    Yasuhisa Izushi & Tsukasa Kiuchi

  2. Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Kita-ku, Okayama, 700-8558, Japan

    Yasuhisa Izushi

  3. Department of Orthopaedic Surgery, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan

    Naofumi Shiota & Toru Sato

  4. Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan

    Tomonori Tetsunaga

  5. Pharmaceutical Care and Health Sciences, School of Pharmacy, Shujitsu University, 1-6-1 Nishigawara, Naka-ku, Okayama, 703-8516, Japan

    Kenichi Shimada, Takashi Egawa & Yoichiro Takami

  6. Department of Pharmacy, Shikoku Medical Center for Children and Adults, 2-1-1 Senyucho, Zentuuji-shi, Kagawa, 765-8507, Japan

    Ritsugi Takuma

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  1. Yasuhisa Izushi
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  2. Naofumi Shiota
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Correspondence to Yoichiro Takami.

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Izushi, Y., Shiota, N., Tetsunaga, T. et al. The clinical impact of edoxaban for the patients with postoperative anemia after total hip arthroplasty. Eur J Orthop Surg Traumatol 28, 1349–1358 (2018). https://doi.org/10.1007/s00590-018-2212-0

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  • DOI: https://doi.org/10.1007/s00590-018-2212-0

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