title: Decreased venous thromboembolism with injectable vs oral anticoagulation after discharge for major orthopedic surgery.
abstract: The use of outpatient anticoagulation after major orthopedic surgery with oral or injectable anticoagulants is recommended by national guidelines. A retrospective analysis of medical and pharmacy claims data using the PharMetrics Patient-Centric Database Inc, Watertown, Mass, was conducted. After adjusting for covariates, patients receiving warfarin were approximately 30% more likely to experience a venous thromboembolism than those receiving an injectable anticoagulant (6.3% vs 4.8%; adjusted odds ratio, 1.3; 95% confidence interval, 1.1-1.5) by 30 days. The data at 90 days showed similar results. No significant differences in the incidence of major bleeding events between the cohorts were observed (incidence of major bleed <0.4%). These findings support the randomized controlled studies and expand the data to the real-world perspective. Clinicians should evaluate these data alongside the clinical trial data when selecting the safest and most effective prophylactic therapy for postdischarge anticoagulation.
authors: Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, California, USA.
authors: Louis M
authors: LM
authors: Kwong
authors: Laura E
authors: LE
authors: Happe
authors: Ruslan
authors: R
authors: Horblyuk
authors: Eileen
authors: E
authors: Farrelly
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001178:Arthroplasty; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010351:Patient Discharge; D011183:Postoperative Complications / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000517:prevention & control; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D014859:Warfarin