title: Predictive factors for effectiveness and safety of enoxaparin for total knee arthroplasty in aged Japanese patients: a retrospective review.
abstract: BACKGROUND
  The aims of this study were to investigate predictive factors involved in effectiveness and safety of enoxaparin for prevention of postoperative venous thromboembolism in aged Japanese total knee arthroplasty (TKA) patients.
  
  
  METHODS
  Japanese patients over 65 years old who were administered enoxaparin for TKA were enrolled in this study. Their medical records were retrospectively reviewed. Data were corrected at the Izumi Regional Medical Center, from September 2009 to March 2014. Patients were stratified into groups according to whether enoxaparin was effective (no deep vein thrombosis event up to postoperative day 7) or not, and whether they had an adverse drug event (ADE) or not.
  
  
  RESULTS
  A total of 128 patients were included in this study. One hundred five (82.0%) patients were in the effective group and 20 (15.6%) in the adverse drug event (ADE) group. Anemia (13 patients), abnormalities in liver function tests (4 patients), clinically relevant non-major bleeding (4 patients) and urticaria (1 patient) were observed as ADEs. Multivariate logistic regression analysis showed that the serum total protein level at postoperative day 1 (POD1, before enoxaparin administration), was associated with effectiveness of enoxaparin, while the serum total protein and hemoglobin level at POD1 were involved in ADE caused by enoxaparin.
  
  
  CONCLUSIONS
  Although further large scale studies will be warranted, our results suggest that serum total protein level just before enoxaparin treatment for TKA relates to the effectiveness and safety of enoxaparin in a Japanese aged population. In addition, the results indicate that the development of anemia should be carefully monitored during enoxaparin treatment for TKA, particularly in patients with lower levels of serum hemoglobin before treatment.
authors.affiliation: Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.|Department of Pharmacy, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sonoda
authors.affiliation: Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
authors.forename: Yuki
authors.identifier: 0000-0003-1456-7721
authors.initials: Y
authors.lastname: Kondo
authors.affiliation: Department of Orthopedic Surgery, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsuneyoshi
authors.affiliation: Department of Pharmacy, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwashita
authors.affiliation: Department of Pharmacy, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakao
authors.affiliation: Department of Pharmacy, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Oniki
authors.affiliation: Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Saruwatari
authors.affiliation: Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.|Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
authors.forename: Tetsumi
authors.initials: T
authors.lastname: Irie
authors.affiliation: Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ishitsuka
keywords: Adverse drug event; Anemia; Enoxaparin; Serum total protein; Total knee arthroplasty; Venous thromboembolism