Assessesment of Abnormal Coagulation as a Risk Factor After
This study assesses a preoperative abnormal coagulation profile as a risk factor for postoperative complications following THA, rTHA, TKA, and rTKA and then examines specific coagulopathies to determine their influence on complication rates. Patients undergoing TJA have an increased likelihood of having an abnormal coagulation profile compared to the general population. Coagulation abnormalities are often screened for before surgery and considered during perioperative planning.

Patients who had THA, rTHA, TKA, or rTKA were identified and their preoperative coagulation profiles were evaluated. For each cohort, various postoperative complications were examined, and two separate multivariate regression (MVR) tests were used to determine the connection between abnormal coagulation and postoperative complications.

Results:
--403,566 THA, rTHA, TKA, or rTKA cases were identified, 40,466 of patients were found to have an abnormal coagulation profile.

--Patients with preoperative coagulation abnormalities had higher likelihoods of postoperative complications after primary TJA than in revision TJA.

--An INR more than 1.2 was associated with the most types of postoperative complications, followed by a bleeding disorder diagnosis.

--A PTT more than 35 seconds was associated with only one type of postoperative complication, while a platelet count less than 150,000 per micro L was associated with postoperative complications only following TKA.

To summarize, TJA in patients with irregular coagulation profiles can have negative consequences. Pre-operative intervention can be beneficial for these patients. Prophylactic treatment must be tailored to the various coagulation disorders that have been identified.

Source: https://www.sciencedirect.com/science/article/abs/pii/S088354032100396X?dgcid=rss_sd_all
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