The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study

<i>Background and Objectives</i>: Hip surgery is increasingly performed among elderly patients. Oral antithrombotics, which are taken for patients’ underlying diseases, are a main concern regarding perioperative bleeding. Postoperative venous thromboembolism (VTE) is a leading cause of m...

Full description

Saved in:
Bibliographic Details
Main Authors: Yea-Ji Lee, Jaemoon Lee, Seung-Wan Hong, Seong-Hyop Kim
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/61/4/729
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849713785866027008
author Yea-Ji Lee
Jaemoon Lee
Seung-Wan Hong
Seong-Hyop Kim
author_facet Yea-Ji Lee
Jaemoon Lee
Seung-Wan Hong
Seong-Hyop Kim
author_sort Yea-Ji Lee
collection DOAJ
description <i>Background and Objectives</i>: Hip surgery is increasingly performed among elderly patients. Oral antithrombotics, which are taken for patients’ underlying diseases, are a main concern regarding perioperative bleeding. Postoperative venous thromboembolism (VTE) is a leading cause of mortality after hip surgery. Therefore, administration of preoperative oral antithrombotics is a double-edged sword in hip surgery. In this study, we examined the correlation between the occurrence of postoperative VTE and the type of oral antithrombotics administered preoperatively. <i>Materials and Methods</i>: We analyzed the medical records of 601 patients aged 19 and over who underwent hip surgery from January 2021 to June 2023. The patients were assigned to two groups as follows: Groups VTE+ (patients who developed postoperative VTE) and VTE- (patients who did not develop postoperative VTE), respectively. <i>Results</i>: Of the 139 patients who had been taking oral antithrombotics for 6 months or more, 24 were allocated to group VTE+ and 115 to group VTE-, respectively. The number of patients who took clopidogrel and cilostazol was significantly higher in groups VTE- and VTE+, respectively (12.5 vs. 33.9%, <i>p</i> = 0.038, odds ratio (OR) = 0.278, 95% confidence interval (CI) = 0.078–0.991; 20.8 vs. 5.2%, <i>p</i> = 0.010, 95% CI = 1.325–17.245; group VTE+ vs. group VTE-). Preoperative albumin levels were significantly lower in group VTE+ (3.4 ± 0.6 g/dL vs. 3.7 ± 0.4 g/dL, <i>p</i> = 0.004, OR = 0.285, 95% CI = 0.115–0.702). In multivariate regression analysis, the results were statistically significant for clopidogrel, cilostazol, and preoperative albumin levels (<i>p</i> = 0.035, OR = 0.237, 95% CI = 0.062–0.901; <i>p</i> = 0.011, OR = 6.479, 95% CI = 1.542–27.226; <i>p</i> = 0.002, OR = 0.211, 95% CI = 0.080–0.558). <i>Conclusions</i>: Among the patients who had been taking oral antithrombotics for ≥6 months, clopidogrel had a prophylactic effect, but cilostazol showed an aggravating effect on postoperative VTE in hip surgery. Preoperative hypoalbuminemia increases the risk of postoperative VTE in hip surgery.
format Article
id doaj-art-d0789fb8d3da46f3a2a98e6519d9c0b9
institution DOAJ
issn 1010-660X
1648-9144
language English
publishDate 2025-04-01
publisher MDPI AG
record_format Article
series Medicina
spelling doaj-art-d0789fb8d3da46f3a2a98e6519d9c0b92025-08-20T03:13:52ZengMDPI AGMedicina1010-660X1648-91442025-04-0161472910.3390/medicina61040729The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective StudyYea-Ji Lee0Jaemoon Lee1Seung-Wan Hong2Seong-Hyop Kim3Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Seoul 05030, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Seoul 05030, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Seoul 05030, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Seoul 05030, Republic of Korea<i>Background and Objectives</i>: Hip surgery is increasingly performed among elderly patients. Oral antithrombotics, which are taken for patients’ underlying diseases, are a main concern regarding perioperative bleeding. Postoperative venous thromboembolism (VTE) is a leading cause of mortality after hip surgery. Therefore, administration of preoperative oral antithrombotics is a double-edged sword in hip surgery. In this study, we examined the correlation between the occurrence of postoperative VTE and the type of oral antithrombotics administered preoperatively. <i>Materials and Methods</i>: We analyzed the medical records of 601 patients aged 19 and over who underwent hip surgery from January 2021 to June 2023. The patients were assigned to two groups as follows: Groups VTE+ (patients who developed postoperative VTE) and VTE- (patients who did not develop postoperative VTE), respectively. <i>Results</i>: Of the 139 patients who had been taking oral antithrombotics for 6 months or more, 24 were allocated to group VTE+ and 115 to group VTE-, respectively. The number of patients who took clopidogrel and cilostazol was significantly higher in groups VTE- and VTE+, respectively (12.5 vs. 33.9%, <i>p</i> = 0.038, odds ratio (OR) = 0.278, 95% confidence interval (CI) = 0.078–0.991; 20.8 vs. 5.2%, <i>p</i> = 0.010, 95% CI = 1.325–17.245; group VTE+ vs. group VTE-). Preoperative albumin levels were significantly lower in group VTE+ (3.4 ± 0.6 g/dL vs. 3.7 ± 0.4 g/dL, <i>p</i> = 0.004, OR = 0.285, 95% CI = 0.115–0.702). In multivariate regression analysis, the results were statistically significant for clopidogrel, cilostazol, and preoperative albumin levels (<i>p</i> = 0.035, OR = 0.237, 95% CI = 0.062–0.901; <i>p</i> = 0.011, OR = 6.479, 95% CI = 1.542–27.226; <i>p</i> = 0.002, OR = 0.211, 95% CI = 0.080–0.558). <i>Conclusions</i>: Among the patients who had been taking oral antithrombotics for ≥6 months, clopidogrel had a prophylactic effect, but cilostazol showed an aggravating effect on postoperative VTE in hip surgery. Preoperative hypoalbuminemia increases the risk of postoperative VTE in hip surgery.https://www.mdpi.com/1648-9144/61/4/729antithromboticship surgerypostoperative complicationsvenous thromboembolism
spellingShingle Yea-Ji Lee
Jaemoon Lee
Seung-Wan Hong
Seong-Hyop Kim
The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study
Medicina
antithrombotics
hip surgery
postoperative complications
venous thromboembolism
title The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study
title_full The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study
title_fullStr The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study
title_full_unstemmed The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study
title_short The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study
title_sort type of preoperative oral antithrombotics as a risk factor for venous thromboembolism after hip surgery a retrospective study
topic antithrombotics
hip surgery
postoperative complications
venous thromboembolism
url https://www.mdpi.com/1648-9144/61/4/729
work_keys_str_mv AT yeajilee thetypeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT jaemoonlee thetypeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT seungwanhong thetypeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT seonghyopkim thetypeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT yeajilee typeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT jaemoonlee typeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT seungwanhong typeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy
AT seonghyopkim typeofpreoperativeoralantithromboticsasariskfactorforvenousthromboembolismafterhipsurgeryaretrospectivestudy