Upper gastrointestinal bleeding after hip and knee arthroplasty.
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants increases the risk of upper gastrointestinal bleeding. This article assesses its incidence in patients undergoing hip and knee arthroplasty. A single-center, retrospective study was conducted on 100 consecutive hip and 100 consecutive knee arthroplasties performed at the Victoria Infirmary, Glasgow, between 1998 and 2000. Sixty-three percent of patients were women with a mean age of 74. Fifty-four percent of patients received NSAIDs and all patients received anticoagulants perioperatively. Four and a half percent of patients had upper gastrointestinal bleeding postoperatively. We believe that the incidence of upper gastrointestinal bleeding as a complication is underestimated and recommend gastro-protective agents in the perioperative period for patients on NSAIDs.
Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom.
Sunil
S
Sharma
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D001471:Barrett Esophagus / Q000175:diagnosis / Q000188:drug therapy; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000188:drug therapy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000175:diagnosis / Q000188:drug therapy; D020246:Venous Thrombosis / Q000517:prevention & control
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D054328:Proton Pump Inhibitors; D001241:Aspirin