Anticoagulation prophylaxis practice patterns in patients having total hip, total knee replacement in a US health plan.

This study aims to illuminate anticoagulation prophylaxis practice patterns in the United States after total joint replacement surgery, with specific attention to duration of overlapping therapy for patients who are "bridged" from low-molecular-weight heparin (LMWH) to warfarin. A large hospital dru...

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Publicado en:Formulary Vol. 46; no. 11; pp. 486 - 495
Autores principales: Baser, Onur, Wang, Li, Supina, Dylan, Sengupta, Nishan
Formato: research tables/charts Journal Article
Publicado: MJH Life Sciences Nov2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2011
      vid: 46
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        atl: Anticoagulation prophylaxis practice patterns in patients having total hip, total knee replacement in a US health plan.
      aug:
        au:
          Baser, Onur
          Wang, Li
          Supina, Dylan
          Sengupta, Nishan
        affil: Adjunct professor of internal medicine, University of Michigan
      sug:
        subj:
          Arthroplasty, Replacement, Knee Adverse Effects
          Arthroplasty, Replacement, Hip Adverse Effects
          Anticoagulants Therapeutic Use
          Venous Thromboembolism Prevention and Control
          Prescribing Patterns
          Funding Source
          Databases
          Billing and Claims
          Hospitals
          International Classification of Diseases
          Adult
          Male
          Female
          Human
          Middle Age
          Aged
          Aged, 80 and Over
          Severity of Illness Indices
          Treatment Outcomes
          Descriptive Statistics
          Poisson Distribution
          Incidence
          Data Analysis Software
          Anticoagulants Adverse Effects
          Retrospective Design
          Treatment Duration
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: This study aims to illuminate anticoagulation prophylaxis practice patterns in the United States after total joint replacement surgery, with specific attention to duration of overlapping therapy for patients who are "bridged" from low-molecular-weight heparin (LMWH) to warfarin. A large hospital drug database and linked outpatient files were retrospectively analyzed and compared for demographic, clinical, and provider characteristics. Of 2,280 enrollees, 1,770 met eligibility criteria, 1,551 received anticoagulant prophylaxis, 692 received only LMWH, and 595 received only warfarin. Of patients who were bridged from one agent to the other, 94% had less than 5 days of overlap. Each day of overlapping prophylaxis was associated with a 0.857 times decreased risk-adjusted incidence rate of thromboembolic events. Rates were 0.957 times lower for major bleeding and 0.895 times lower for minor bleeding for each day of overlap. In this analysis, longer duration of overlapping therapy is associated with decreased adverse event rates of both venous thromboembolism and bleeding.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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