Evidence map›Paper›PMID 31879493›Full record

ArticleJournal of orthopaedics

Interruption of long-term warfarin is not necessary in patients undergoing total hip arthroplasty.

Mohamed Mussa, Pratheek Chikkalur, James Isbister, Shreeram Deshpande, Eric Isbister

Open access · greenAbstract read
In one paragraph

Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Mohamed MussaThe Royal Wolverhampton NHS Trust, UK.
Pratheek ChikkalurThe Royal Wolverhampton NHS Trust, UK.
James IsbisterThe Royal Wolverhampton NHS Trust, UK.
Shreeram DeshpandeThe Royal Wolverhampton NHS Trust, UK.
Eric IsbisterThe Royal Wolverhampton NHS Trust, UK.
The Royal Wolverhampton NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe management of anticoagulation in patients undergoing arthroplasty remains a challenge. Guidelines for perioperative management of long-term warfarin recommend discontinuation of warfarin preoperatively in low risk patients. We hypothesised that patients who had their warfarin continued during the perioperative period would have shorter hospital stay and no significant increase risk of surgical complications compared to patients who had their warfarin interrupted.

methodsThis was a retrospective review of 20 consecutive patients receiving long-term warfarin who underwent total hip replacement without stopping warfarin. As a control group, we collected same data from 20 age and gender matched patients also on long term warfarin but their warfarin was stopped prior to surgery and restarted postoperatively.

resultsThere was no significant difference in age, BMI or comorbidities between the 2 groups. There was a statistically significant difference between the two groups in postoperative INR (P < 0.0001) levels. The mean drop in Hb postoperatively was 25.95 g/L in the warfarin group and 35.7 g/L in the control group, which was statistically significant (P = 0.0066). Hospital stay was statistically significant with shorted stay observed in the warfarin group (P = 0.0447). The odds ratio for developing a postoperative complication was 1.5882 which was not statistically significant (P = 0.6346).

conclusionOur results support the hypothesis that it is safe to continue warfarin in patients on long term anticoagulation undergoing total hip replacement. Continuation of warfarin was associated with significantly shorter hospital stay and less INR fluctuations. There was no significant increase in the risk of complications or blood transfusion.

Indexed as

ComplicationsElective total hip replacementHospital stayOral anticoagulationWarfarin

Identifiers

PMID31879493
PMCPMC6919369
OpenAlexW2954381732

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.