- 作者：Masahiro Hasegawa ; Hideo Wada ; Hiroki Wakabayashi ; Kakunoshin Yoshida ; Noriki Miyamoto ; Kunihiro Asanuma ; Takeshi Matsumoto ; Kohshi Ohishi ; Yuji Shimokariya ; Norikazu Yamada ; Atsumasa Uchida ; Akihiro Sudo
- 关键词：Deep vein thrombosis (DVT) ; Anti-Xa activity ; Fondaparinux ; Orthopedic surgery ; Withdrawal
- 刊名：Clinica Chimica Acta
- 出版年：2013
- 出版时间：21 October, 2013
- 年：2013
- 卷：425
- 期：Complete
- 页码：109-113
- 全文大小：526 K
Background
The relationships among the hemostatic markers, the development of deep vein thrombosis (DVT) and the withdrawal of fondaparinux due to a reduction in the hemoglobin levels were examined.Methods
Two-hundred twenty-one Japanese patients who underwent major orthopedic surgery and were treated with 1.5 mg of fondaparinux instead of 2.5 mg of fondaparinux were studied. Forty-seven of 221 patients discontinued fondaparinux treatment (withdrawal group) and 37 patients developed DVT.
Results
The age, frequency of total knee arthroplasty (TKA), withdrawal of fondaparinux, reduction of hemoglobin and the plasma levels of soluble fibrin (SF), D-dimer and fibrinogen and fibrin degradation product (FDP) on day 1 after the operation were significantly higher in the patients with DVT. Elevated SF, D-dimer or FDP levels were associated with the risk for DVT. The age, frequency of TKA or DVT, anti-Xa activity and the creatinine, FDP and D-dimer levels were significantly higher in the withdrawal group. An anti-Xa level > 0.33 mg/l and an elevated D-dimer or FDP level were associated with the risk of withdrawal.
Conclusion
The age and SF levels, TKA and withdrawal of fondaparinux were related to the risk of DVT, and the anti-Xa activity, creatinine level and DVT were related to the risk of withdrawal of fondaparinux due to a reduction in hemoglobin.