Nicholas Erdle
Tanzania
Research Article
Pre versus Post-Operative Initiation of Warfarin Therapy in Patients undergoing Total Hip and Knee Arthroplasty
Author(s): Cara Cipriano, Nicholas Erdle, Kai Li and Brian CurtinCara Cipriano, Nicholas Erdle, Kai Li and Brian Curtin
Background: The optimal strategy for postoperative Deep Venous Thrombosis (DVT) prophylaxis remains among the most controversial topics in hip and knee arthroplasty. Warfarin, the most commonly used chemical anticoagulant, initially causes transient hypercoagulability; however the optimal timing of treatment with respect to surgery remains unclear. Our purpose was to evaluate the effects of pre- versus postoperative initiation of warfarin therapy with a primary endpoint of perioperative change in hemoglobin (pre- minus post-operative level), with secondary endpoints of postoperative International Normalized Ratio (INR), drain output, and bleeding/thrombotic events.
Methods: A quasi-experimental study design was employed, under which patients were assigned to begin taking warfarin the night prior to surgery or the night following surgery base.. View More»
