Efficacy And Safety Of Single-dose Anticoagulant Treatment In Preventing Venous Thromboembolism After Revision Hip Arthroplasty

Objective:To analyze the efficacy and safety of single-dose anticoagulant treatment in preventing venous thromboembolism and independent risk factors of VTE and wound complications after revision hip arthroplasty.Methods : The data of 295 patients who underwent revision hip arthroplasty in our hospital from June 2015 to January 2022 were retrospectively analyzed.They were divided into single-dose group and multiple-dose group according to the adopted VTE prophylaxis protocol.Multiple-dose group:40 mg low-molecular-weight heparin once and oral 10 mg rivaroxaban for 10 days.Single-dose group:40 mg low-molecular-weight heparin once.The patients in both groups performed active lower limb exercises.Each group was further stratified into aseptic revision subgroup and septic revision subgroup based on the etiology of revision hip arthroplasty.We compared the differences in the incidence rate of postoperative VTE,wound complications,hidden blood loss volume,postoperative blood transfusion rate,and duration of drainage tube retention between the two groups and occurrence of other postoperative adverse events.In addition,we used logistic regression to analyze the risk factors of VTE and wound complications after revision hip arthroplasty.Results:The incidence rates of VTE did not differ between the two groups.However,the incidence rate of wound complications(P=0.002),hidden blood loss amount(P=0.015)and postoperative transfusion rate(P=0.028)in the single-dose group was lower than that in the multiple-dose group.The duration of surgical drainage was shorter than that in the multiple-dose group(P=0.002).However,in the septic revision subgroup,the HBL and postoperative transfusion rate were not different in the single-dose group and multiple-dose group.The use of multiple-dose anticoagulants(OR=2.887,P=0.002)and high BMI(OR=1.086,P=0.037)were independent risk factors of wound complications.Conclusion : Compared with multiple-dose chemoprophylaxis protocol,postoperative single-dose anticoagulant combined with active lower limb exercise did not increase the incidence rate of VTE,but significantly reduced the occurrence of wound complications,hidden blood loss,transfusion rate,and duration of surgical drain after revision hip arthroplasty,which can be used as a new strategy to prevent VTE after revision hip arthroplasty.