Prostate Cancer History and Total Hip Arthroplasty: A Matched Cohort Analysis Investigating Venous Thromboembolism and Anticoagulation
UMass Chan AffiliationsOrthopedics and Physical Rehabilitation
Document TypeJournal Article
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AbstractBackground: Prostate cancer (PCa) is a common cancer among men in the United States. While malignancy is a known cause of venous thromboembolism (VTE), little is known about the effect of PCa history on postoperative complications after elective total hip arthroplasty (THA). This study aimed to evaluate the risk of hematologic complications in patients with a history of PCa taking common postoperative anticoagulants. Methods: THA patients were identified through the PearlDiver Mariner database. Patients with a history of PCa were placed in one of the following cohorts based on postoperative anticoagulant prescription: aspirin, warfarin, low-molecular-weight heparin, direct Xa inhibitor, or any anticoagulant. PCa cohorts were matched 1:3 to patients without a history of PCa with the same anticoagulant prescription based on age, gender, and Charlson Comorbidity Index. Postoperative complications were evaluated using multivariable logistic regression. Results: A total of 74,744 patients that underwent THA were included. PCa patients taking any anticoagulant were found to have increased risk of postoperative deep vein thrombosis (DVT) (odds ratio: 1.25, lower 99% confidence interval: 1.09, upper 99% confidence interval: 1.43, P value <.001). PCa patients taking warfarin, low-molecular-weight heparin, and direct Xa inhibitors additionally showed increased risk of postoperative DVT. Patients taking aspirin did not have an increased risk of postoperative DVT. Conclusions: Our results suggest postoperative aspirin prophylaxis may not increase VTE complication risk when compared to other anticoagulants. Surgeons should be aware that PCa history may be an independent risk factor for VTE, and these patients may benefit from medical optimization.
SourceJohnson K, Clegg S, Alsoof D, Daniels AH, Deren ME, Cohen EM. Prostate Cancer History and Total Hip Arthroplasty: A Matched Cohort Analysis Investigating Venous Thromboembolism and Anticoagulation. Arthroplast Today. 2022 Sep 20;17:198-204.e2. doi: 10.1016/j.artd.2022.07.020. PMID: 36254211; PMCID: PMC9568672.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/51284
Rights© 2022 Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).; Attribution-NonCommercial-NoDerivatives 4.0 International
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Except where otherwise noted, this item's license is described as © 2022 Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).