Izushi Yasuhisa, Shiota Naofumi, Tetsunaga Tomonori, Ookura Yusuke, Sato Toru, Kitamura Yoshihisa
Department of Pharmacotherapy, School of Pharmacy, Shujitsu University, Okayama, JPN.
Division of Molecular and Cellular Medicine, Department of Clinical Science, National Hospital Organization Okayama Medical Centre, Okayama, JPN.
Cureus. 2024 Jul 11;16(7):e64320. doi: 10.7759/cureus.64320. eCollection 2024 Jul.
Background An increased risk of anemia during edoxaban thromboprophylaxis in orthopedic surgery has been reported. However, the risk factors for the exacerbation of anemia requiring transfusion with irradiated red blood cell concentrates during postoperative edoxaban thromboprophylaxis remain unknown. Therefore, this study investigated the factors that increase the possibility of transfusion during edoxaban thromboprophylaxis after orthopedic surgery by reanalyzing clinical data from a previous collection. Methods A total of 221 patients who underwent total hip or knee arthroplasty at a single center between July 2011 and June 2012 were included in this study. Among these, 167 patients who received 30 mg of postoperative edoxaban thromboprophylaxis were retrospectively analyzed to identify critical factors for transfusion during edoxaban thromboprophylaxis after orthopedic surgery. Results Lower preoperative hemoglobin levels and higher intraoperative blood loss per body weight were significantly associated with an increase in the frequency of transfusion during postoperative edoxaban thromboprophylaxis. These factors were also potentially related to increased coagulation parameters during edoxaban thromboprophylaxis. Conclusion Our study shows that lower preoperative hemoglobin levels and higher intraoperative blood loss are associated with increased coagulation parameters with edoxaban thromboprophylaxis after orthopedic surgery and may lead to worsening of anemia, thereby requiring blood transfusion.
有报道称，在骨科手术中使用依度沙班进行血栓预防时贫血风险增加。然而，术后使用依度沙班进行血栓预防期间，导致需要输注辐照红细胞浓缩物的贫血加重的危险因素仍不清楚。因此，本研究通过重新分析先前收集的临床数据，调查了骨科手术后使用依度沙班进行血栓预防期间增加输血可能性的因素。方法：本研究纳入了2011年7月至2012年6月期间在单一中心接受全髋关节或膝关节置换术的221例患者。其中，对167例接受术后30mg依度沙班血栓预防的患者进行回顾性分析，以确定骨科手术后使用依度沙班进行血栓预防期间输血的关键因素。结果：术前血红蛋白水平较低和术中每体重失血较多与术后依度沙班血栓预防期间输血频率增加显著相关。这些因素也可能与依度沙班血栓预防期间凝血参数增加有关。结论：我们的研究表明，术前血红蛋白水平较低和术中失血较多与骨科手术后使用依度沙班进行血栓预防时凝血参数增加有关，可能导致贫血恶化，从而需要输血。
