Evidence map›Paper›PMID 39478686›Full record

ArticleJournal of experimental orthopaedics2024

Personalized delayed anticoagulation therapy alleviates postoperative bleeding in total knee arthroplasty (TKA) patients.

Xuefeng Luo, Dehua Wang, Wei Xu, Jing Zou, Runxing Kang, Tao Zhang, Xi Liang, Junyi Liao, Wei Huang

Abstract read
In one paragraph

Article in Journal of experimental orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xuefeng LuoDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.
Dehua WangDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.
Wei XuDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.
Jing ZouChongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine Orthopaedic Research Laboratory of Chongqing Medical University Chongqing China.
Runxing KangDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.
Tao ZhangDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.
Xi LiangDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.
Junyi LiaoDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.ORCID 0000-0002-9212-7484
Wei HuangDepartment of Orthopaedic Surgery The First Affiliated Hospital of Chongqing Medical University Chongqing China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Ecchymosis is one of the most common complications following total knee arthroplasty (TKA), which is closely related to postoperative bleeding. However, it is still controversial whether anticoagulation treatment should be continued for postoperative ecchymosis patients. We suppose that personalized delayed anticoagulation therapy could be beneficial for decreasing postoperative bleeding. Methods: A total of 201 TKA patients were retrospectively included in this study, among whom ecchymosis patients received drug anticoagulation treatment 1-2 days later than usual, while nonecchymosis patients received regular drug anticoagulation treatment. The perioperative blood loss, coagulation state, fibrinolytic state and complications were collected and analyzed. Results: Eighty-nine patients (44.3%) developed ecchymosis within 3 days after TKA. There were no differences in baseline characteristics between the two groups. In the ecchymosis group, higher K values and lower calculated coagulation index values were observed in thromboelastography, along with greater total blood loss and a more significant decrease in haemoglobin levels on postoperative Day 1 (POD1) compared to the nonecchymosis group. Additionally, the ecchymosis patients exhibited higher levels of fibrinogen degradation products and D-dimer (D-D) on POD1, with no differences noted on POD3, indicating that patients with ecchymosis are in a relatively hypocoagulable and hyperfibrinolytic state compared to those without ecchymosis. Therefore, the delayed anticoagulation treatment proved beneficial for correcting these postoperative conditions. No statistically significant differences were found between the two groups in postoperative complications, demonstrating that delayed anticoagulation treatment is safe. Conclusion: Patients with ecchymosis exhibited a relatively hypocoagulable and hyperfibrinolytic state with a stronger tendency for postoperative bleeding. Delayed anticoagulation in ecchymosis patients could effectively prevent further exacerbation of postoperative bleeding by avoiding sustained hypocoagulable and hyperfibrinolysis states. Personalized delayed anticoagulation therapy could be beneficial for managing postoperative ecchymosis for TKA patients. Level of Evidence: Level IV.

Indexed as

ecchymosishyperfibrinolysisperioperative bleedingpersonalized delayed anticoagulationtotal knee arthroplasty

Identifiers

PMID39478686
PMCPMC11522910

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.