Thromboelastography In Assessment Of Blood Coagulation Function Changes In Perioperative Patients Undergoing Arthroplasty

Objective:To assess the coagulation status of patients undergoing arthroplasty after administration of rivaroxaban with thromboelastograph (TEG) in perioperative period, and to analyze the relation between coagulation status and blood platelet count. Methods:Eighty-six patients undergoing arthroplasty in our department in 2014 were included prospectively. All the patients were treated with 10 mg of rivaroxaban 12 hours after operation to prevent blood clots. TEG parameters and platelet count were analysed simultaneously on the day before operation and on postoperative days 1,3,5 and 7. The proportion of hypercoagulability and mean platelet count were compared at different time points. And the correlation between hypercoagulable states and platelet count was performed with the use of correlation analysis. Results:There were significant changes in the distribution of different hypercoagulable states on days 1-3 and on days 3-7. Seven days after operation,86% of patients were found with hypercoagulable state. Of these patients with hypercoagulable state 90.5% patients demonstrated platelet or mixed hypercoagulability, which means MA values are greater than 70 mm. On day 3 after operation, the average amount of platelet count decreased slightly than that before opertation (P=0.0600),but it showed significantly higher (P=0.000) than the preoperative level on day 7 after operation. We also found positive correlation between MA and platelet count during the progress. Conclusions: TEG result indicates that the proportion of patients with hypercoagulable state can not be reduced by a short time application of rivaroxaban.The increase of platelet count after operation may play an important role in the progress of blood hypercoagulability.