Антикоагулянти підвищують ризик інфекцій
Додано: 30 серпня 2018, 17:19
Колеги !!
Кілька разів зустрічався з публікаціями, що антикоакулянти підвищують ризик розвитку інфекційних раневих ускладнень (SSI - surgical site infection). І ось ще цитата з матеріалів AAOS. Ривароксабан збільшує в два рази ... в порівнянні з НМГ ... при протезуванні кульшового суглоба. Чи є у кого свої власні спостереження?
a multi-center study by Jameson et al comparing low molecular weight heparins for thromboprophylaxis was recently published. English hospital trusts replaced low molecular weight heparin with rivaroxaban for prophylaxis in lower-limb arthroplasty. There were significantly fewer wound complications in the low molecular weight heparin group (2.81% vs 3.85%; p=0.005). There was no difference in rates of pulmonary embolism, major bleeding or all-cause mortality. Jensen et al also noted a greater number of wound complications (1.8% vs 3.94%; p=0.046) in patients receiving rivaroxaban compared to tinzaparin. The morbidity of repeat surgeries associated with rivaroxaban without a reported benefit of fewer pulmonary emboli events is of great concern. The concern is especially relevant as the control or comparison group treatment (low molecular weight heparin) has also been associated with increased wound drainage and infection when compared to other means of thromboembolic disease prevention
Кілька разів зустрічався з публікаціями, що антикоакулянти підвищують ризик розвитку інфекційних раневих ускладнень (SSI - surgical site infection). І ось ще цитата з матеріалів AAOS. Ривароксабан збільшує в два рази ... в порівнянні з НМГ ... при протезуванні кульшового суглоба. Чи є у кого свої власні спостереження?
a multi-center study by Jameson et al comparing low molecular weight heparins for thromboprophylaxis was recently published. English hospital trusts replaced low molecular weight heparin with rivaroxaban for prophylaxis in lower-limb arthroplasty. There were significantly fewer wound complications in the low molecular weight heparin group (2.81% vs 3.85%; p=0.005). There was no difference in rates of pulmonary embolism, major bleeding or all-cause mortality. Jensen et al also noted a greater number of wound complications (1.8% vs 3.94%; p=0.046) in patients receiving rivaroxaban compared to tinzaparin. The morbidity of repeat surgeries associated with rivaroxaban without a reported benefit of fewer pulmonary emboli events is of great concern. The concern is especially relevant as the control or comparison group treatment (low molecular weight heparin) has also been associated with increased wound drainage and infection when compared to other means of thromboembolic disease prevention