Asian populations have a lower rate of high-risk gene mutations of venous thrombosis, which means a reasonable perioperative anticoagulant management after hip or knee arthroplasty for Caucasian populations may be too excessive for Asians. So, individual patient risk assessment, rather than a "blanket policy", is considered the best thromboembolism prophylaxis for Asians.The purpose of this study was to evaluate the effectiveness and safety of selective thromboembolism prophylaxis compared with conventional thromboembolism prophylaxis by risk stratification with thromboelastography (TEG) after joint arthroplasty for Asian populations.
Asian patients who underwent hip or knee arthroplasty in Guangdong General Hospital from August 2016 to August 2017 were randomly divided into selective anticoagulation group (SAG) and conventional anticoagulation group (CAG). SAG used anticoagulant when TEG indicated hypercoagulability while CAP used anticoagulant until one month after surgery regularly. Data including patients' basic information, postoperative complications, perioperative clotting index, intraoperative blood loss, perioperative TEG, volume of drainage, and blood transfusion were evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
197
Selective anticoagulation group used anticoagulant once thromboelastography indicated hypercoagulable state. Conventional anticoagulation group used anticoagulant until one month after surgery routinely. The main difference was that the experimental group did not use anticoagulation if the thromboelastography indicated that the blood coagulation status was normal while the control group use anticoagulation routinely.
The Incidence of Deep Vein Thrombosis
Measured by ultrasound,
Time frame: 1 day after surgery
The Incidence of Deep Vein Thrombosis
Measured by ultrasound
Time frame: 3 days after surgery
The Incidence of Deep Vein Thrombosis
Measured by ultrasound
Time frame: 5 days after surgery
The Incidence of Deep Vein Thrombosis
Measured by ultrasound
Time frame: 1 month after surgery
The Incidence of Deep Vein Thrombosis
Measured by ultrasound
Time frame: 3 months after surgery
The Incidence of Deep Vein Thrombosis
Measured by ultrasound
Time frame: 6 months after surgery
Hematocrit
Measured by Complete Blood Count
Time frame: 1 day before surgery
Hematocrit
Measured by Complete Blood Count
Time frame: 1 day after surgery
Hematocrit
Measured by Complete Blood Count
Time frame: 3 days after surgery
Hematocrit
Measured by Complete Blood Count
Time frame: 5 days after surgery
Hemoglobin
Number of Hemoglobin Measured by Blood Test
Time frame: 1 day before surgery
Hemoglobin
Number of Hemoglobin Measured by Blood Test
Time frame: 1 day after surgery
Hemoglobin
Number of Hemoglobin Measured by Blood Test
Time frame: 3 days after surgery
Hemoglobin
Number of Hemoglobin Measured by Blood Test
Time frame: 5 days after surgery
Red Blood Cell
Number of Red Blood Cell Measured by Complete Blood Count
Time frame: 1 day before surgery
Red Blood Cell
Number of Red Blood Cell Measured by Complete Blood Count
Time frame: 1 day after surgery
Red Blood Cell
Number of Red Blood Cell Measured by Complete Blood Count
Time frame: 3 days after surgery
Red Blood Cell
Number of Red Blood Cell Measured by Complete Blood Count
Time frame: 5 days after surgery
Volume of Transfusion
Volume of Blood Transfusion
Time frame: During Hospitalization
Transfusion Rate
Number of patients who receive transfusion divided by total number of patients in the group
Time frame: During Hospitalization
Superficial Infection
Number of patients who suffer superficial infection
Time frame: During Hospitalization
Superficial Infection
Number of patients who suffer superficial infection
Time frame: 1 month after surgery
Superficial Infection
Number of patients who suffer superficial infection
Time frame: 3 months after surgery
Superficial Infection
Number of patients who suffer superficial infection
Time frame: 6 months after surgery
Deep Infection
Number of patients who suffer deep infection
Time frame: During Hospitalization
Deep Infection
Number of patients who suffer deep infection
Time frame: 1 month after surgery
Deep Infection
Number of patients who suffer deep infection
Time frame: 3 months after surgery
Deep Infection
Number of patients who suffer deep infection
Time frame: 6 months after surgery
Ecchymosis incidence Rate
Number of patients who suffer ecchymosis divided by total number of patients in the group
Time frame: 1 month after surgery
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