Does subcutaneous administration of recombinant human erythropoietin increase thrombotic events in total hip arthroplasty? A prospective thrombelastography analysis.
Aged
Anemia
/ drug therapy
Arthroplasty, Replacement, Hip
/ adverse effects
Erythropoietin
/ administration & dosage
Female
Humans
Injections, Subcutaneous
Male
Middle Aged
Perioperative Period
Postoperative Complications
/ drug therapy
Prospective Studies
Recombinant Proteins
/ administration & dosage
Severity of Illness Index
Thrombelastography
Thrombosis
/ chemically induced
Perioperative anemia
Recombinant human erythropoietin
Thrombelastography
Thrombotic events
Total hip arthroplasty
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
19 Nov 2020
19 Nov 2020
Historique:
received:
06
09
2020
accepted:
10
11
2020
entrez:
20
11
2020
pubmed:
21
11
2020
medline:
22
6
2021
Statut:
epublish
Résumé
Anemia is one of severe complications in the perioperative period of total hip arthroplasty (THA). Erythropoietin (EPO) has been considered to improve patients' anemia state, but its efficiency and safety remains controversial. A total of 152 patients who underwent total hip arthroplasty from January 2017 to March 2019 were randomized to 2 groups. Recombinant human erythropoietin (rHu-EPO) group was treated with rHu-EPO subcutaneous injection 10000 IU after operation and once daily in the next week, while control group was treated with none extra treatment. Routine hematologic examination and thrombelastography (TEG) performed at different time point respectively. Doppler ultrasound for bilateral lower limbs was performed 1 day before surgery and 7 days after surgery. Auxiliary examination outcomes, blood transfusions outcomes, and postoperative complications were recorded as assessment indicators. The difference in the relevant indexes of traditional coagulation and TEG values between two groups were not significantly. No significant difference was observed in the incidence of thromboembolism events and other complications between two groups during postoperative period. The amount of intraoperative blood loss was similar between the two groups. However, the postoperative use and dosage of allogeneic blood in the rHu-EPO group were lower than those in the control group. The hemoglobin and hematocrit level in the rHu-EPO group were higher than that in the control group after surgery. Postoperative subcutaneous injection of rHu-EPO can improve hematological anemia-related parameters, reduce the use and dosage of allogeneic blood transfusions (ABTs), and has no significant influence on the formation of thrombosis and other complications in patients undergoing total hip arthroplasty in short term.
Sections du résumé
BACKGROUND
BACKGROUND
Anemia is one of severe complications in the perioperative period of total hip arthroplasty (THA). Erythropoietin (EPO) has been considered to improve patients' anemia state, but its efficiency and safety remains controversial.
METHODS
METHODS
A total of 152 patients who underwent total hip arthroplasty from January 2017 to March 2019 were randomized to 2 groups. Recombinant human erythropoietin (rHu-EPO) group was treated with rHu-EPO subcutaneous injection 10000 IU after operation and once daily in the next week, while control group was treated with none extra treatment. Routine hematologic examination and thrombelastography (TEG) performed at different time point respectively. Doppler ultrasound for bilateral lower limbs was performed 1 day before surgery and 7 days after surgery. Auxiliary examination outcomes, blood transfusions outcomes, and postoperative complications were recorded as assessment indicators.
RESULTS
RESULTS
The difference in the relevant indexes of traditional coagulation and TEG values between two groups were not significantly. No significant difference was observed in the incidence of thromboembolism events and other complications between two groups during postoperative period. The amount of intraoperative blood loss was similar between the two groups. However, the postoperative use and dosage of allogeneic blood in the rHu-EPO group were lower than those in the control group. The hemoglobin and hematocrit level in the rHu-EPO group were higher than that in the control group after surgery.
CONCLUSION
CONCLUSIONS
Postoperative subcutaneous injection of rHu-EPO can improve hematological anemia-related parameters, reduce the use and dosage of allogeneic blood transfusions (ABTs), and has no significant influence on the formation of thrombosis and other complications in patients undergoing total hip arthroplasty in short term.
Identifiants
pubmed: 33213494
doi: 10.1186/s13018-020-02083-w
pii: 10.1186/s13018-020-02083-w
pmc: PMC7678274
doi:
Substances chimiques
EPO protein, human
0
Recombinant Proteins
0
Erythropoietin
11096-26-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
546Subventions
Organisme : the National Natural Science Foundation of China
ID : 81902244
Organisme : Key Program of Science and Technique Development Foundation in Jiangsu Province
ID : BE2015627
Organisme : Research Project of Jiangsu Provincial Health Department
ID : H201528
Organisme : Jiangsu Provincial Medical Youth Talent
ID : QNRC2016801
Organisme : Xuzhou Science and Technology Innovation Project
ID : KC19063
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