Postmenopausal hormone replacement and venous thromboembolism following hip and knee arthroplasty
Summary Hormone replacement therapy has been associated with venous thromboembolism. Controversy exists regarding the appropriate management of hormone replacement in the perioperative setting and in other situations – such as acute illness – predisposing to acute venous thromboembolism. We performe...
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| Veröffentlicht in: | Thrombosis and haemostasis 2004-08, Vol.92 (2), p.337-343 |
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| creator | Hurbanek, Jason G. Jaffer, Amir K. Morra, Nariman Karafa, Matthew Brotman, Daniel J. |
| description | Summary
Hormone replacement therapy has been associated with venous thromboembolism. Controversy exists regarding the appropriate management of hormone replacement in the perioperative setting and in other situations – such as acute illness – predisposing to acute venous thromboembolism. We performed a case-control study to determine whether perioperative hormone replacement is associated with venous thromboembolism following hip and knee arthroplasty. 108 patients with postoperative venous thrombosis were matched by age, date and type of surgery, and surgeon with 210 controls without thrombosis. Perioperative hormone replacement use was no more prevalent in patients with postoperative thrombosis than those without. Eighteen (16.7%) women with post-operative thrombosis had taken perioperative hormone replacement compared to 49 (23.3%) of controls: odds ratio = 0.66; (95% CI 0.35–1.18; p=0.17). After multivariate analysis, the adjusted odds ratios were similar. Variables predicting post-operative thrombosis included: prior venous thromboembolism (OR = 2.3; p = 0.02), rheumatologic disease (OR = 2.2; p = 0.03), and absence of pharmacologic antithrombotic prophylaxis (OR = 13.4; p = 0.005). Cases and controls were otherwise similar. Users of hormone replacement were similar to non-users except that they were less likely to have coronary disease (OR 0.34; p = 0.03) or prior thrombosis (OR = 0.28; p = 0.04), and were younger (median age 67 versus 74 years; p |
| doi_str_mv | 10.1160/TH04-03-0165 |
| format | Article |
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Hormone replacement therapy has been associated with venous thromboembolism. Controversy exists regarding the appropriate management of hormone replacement in the perioperative setting and in other situations – such as acute illness – predisposing to acute venous thromboembolism. We performed a case-control study to determine whether perioperative hormone replacement is associated with venous thromboembolism following hip and knee arthroplasty. 108 patients with postoperative venous thrombosis were matched by age, date and type of surgery, and surgeon with 210 controls without thrombosis. Perioperative hormone replacement use was no more prevalent in patients with postoperative thrombosis than those without. Eighteen (16.7%) women with post-operative thrombosis had taken perioperative hormone replacement compared to 49 (23.3%) of controls: odds ratio = 0.66; (95% CI 0.35–1.18; p=0.17). After multivariate analysis, the adjusted odds ratios were similar. Variables predicting post-operative thrombosis included: prior venous thromboembolism (OR = 2.3; p = 0.02), rheumatologic disease (OR = 2.2; p = 0.03), and absence of pharmacologic antithrombotic prophylaxis (OR = 13.4; p = 0.005). Cases and controls were otherwise similar. Users of hormone replacement were similar to non-users except that they were less likely to have coronary disease (OR 0.34; p = 0.03) or prior thrombosis (OR = 0.28; p = 0.04), and were younger (median age 67 versus 74 years; p <0.0001). We found no association between perioperative hormone replacement and post-operative thrombosis in patients undergoing major orthopaedic surgery. Routine discontinuation of these medications preoperatively – and possibly in other situations predisposing to thrombosis, such as acute medical illness – may be unnecessary in patients receiving appropriate pharmacologic antithrombotic prophylaxis.</description><identifier>ISSN: 0340-6245</identifier><identifier>EISSN: 2567-689X</identifier><identifier>DOI: 10.1160/TH04-03-0165</identifier><identifier>PMID: 15269830</identifier><identifier>CODEN: THHADQ</identifier><language>eng</language><publisher>Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften</publisher><subject>Acute Disease ; Aged ; Arthroplasty, Replacement, Knee - adverse effects ; Biological and medical sciences ; Blood Coagulation, Fibrinolysis and Cellular Haemostasis ; Blood coagulation. Blood cells ; Case-Control Studies ; Female ; Fundamental and applied biological sciences. Psychology ; Hematologic and hematopoietic diseases ; Hormone Replacement Therapy - adverse effects ; Humans ; Medical sciences ; Middle Aged ; Molecular and cellular biology ; Multivariate Analysis ; Odds Ratio ; Platelet diseases and coagulopathies ; Postmenopause ; Retrospective Studies ; Thromboembolism - etiology ; Thromboembolism - pathology ; Venous Thrombosis - etiology ; Venous Thrombosis - pathology</subject><ispartof>Thrombosis and haemostasis, 2004-08, Vol.92 (2), p.337-343</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c543t-631d7fc001ca19bc399dff16256e12d567c19e291e89744baeaffb70714906ad3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1160/TH04-03-0165.pdf$$EPDF$$P50$$Gthieme$$H</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1160/TH04-03-0165$$EHTML$$P50$$Gthieme$$H</linktohtml><link.rule.ids>314,776,780,3005,27901,27902,54534,54535</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15988174$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15269830$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hurbanek, Jason G.</creatorcontrib><creatorcontrib>Jaffer, Amir K.</creatorcontrib><creatorcontrib>Morra, Nariman</creatorcontrib><creatorcontrib>Karafa, Matthew</creatorcontrib><creatorcontrib>Brotman, Daniel J.</creatorcontrib><title>Postmenopausal hormone replacement and venous thromboembolism following hip and knee arthroplasty</title><title>Thrombosis and haemostasis</title><addtitle>Thromb Haemost</addtitle><description>Summary
Hormone replacement therapy has been associated with venous thromboembolism. Controversy exists regarding the appropriate management of hormone replacement in the perioperative setting and in other situations – such as acute illness – predisposing to acute venous thromboembolism. We performed a case-control study to determine whether perioperative hormone replacement is associated with venous thromboembolism following hip and knee arthroplasty. 108 patients with postoperative venous thrombosis were matched by age, date and type of surgery, and surgeon with 210 controls without thrombosis. Perioperative hormone replacement use was no more prevalent in patients with postoperative thrombosis than those without. Eighteen (16.7%) women with post-operative thrombosis had taken perioperative hormone replacement compared to 49 (23.3%) of controls: odds ratio = 0.66; (95% CI 0.35–1.18; p=0.17). After multivariate analysis, the adjusted odds ratios were similar. Variables predicting post-operative thrombosis included: prior venous thromboembolism (OR = 2.3; p = 0.02), rheumatologic disease (OR = 2.2; p = 0.03), and absence of pharmacologic antithrombotic prophylaxis (OR = 13.4; p = 0.005). Cases and controls were otherwise similar. Users of hormone replacement were similar to non-users except that they were less likely to have coronary disease (OR 0.34; p = 0.03) or prior thrombosis (OR = 0.28; p = 0.04), and were younger (median age 67 versus 74 years; p <0.0001). We found no association between perioperative hormone replacement and post-operative thrombosis in patients undergoing major orthopaedic surgery. Routine discontinuation of these medications preoperatively – and possibly in other situations predisposing to thrombosis, such as acute medical illness – may be unnecessary in patients receiving appropriate pharmacologic antithrombotic prophylaxis.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Blood Coagulation, Fibrinolysis and Cellular Haemostasis</subject><subject>Blood coagulation. Blood cells</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hormone Replacement Therapy - adverse effects</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Molecular and cellular biology</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Platelet diseases and coagulopathies</subject><subject>Postmenopause</subject><subject>Retrospective Studies</subject><subject>Thromboembolism - etiology</subject><subject>Thromboembolism - pathology</subject><subject>Venous Thrombosis - etiology</subject><subject>Venous Thrombosis - pathology</subject><issn>0340-6245</issn><issn>2567-689X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqtkc9rFTEQx4Mo9rV68yx78aSryWZ_5SilWqGghwrewrzsrJu6u1ky2Zb-9876HlYEbx5CCPNhvpnPCPFCybdK1fLd9aUsc6lzqerqkdgVVd3kdWu-PRY7qUuZ10VZnYhTohvJSGmqp-JEVUVtWi13Ar4EShPOYYGVYMyGEKcwYxZxGcEhV1IGc5fdMrJSloYYpn1APqOnKevDOIY7P3_PBr_8An_MiBnEDeQOlO6fiSc9jITPj_eZ-Prh4vr8Mr_6_PHT-fur3FWlTnmtVdf0jv_oQJm908Z0fa9qngdV0fFUThksjMLWNGW5B4S-3zeyUaWRNXT6TLw59HUxEEXs7RL9BPHeKmk3U3YzZaW2mynGXx7wZd1P2D3ARzUMvDoCQA7GPsLsPP3BmbZVTcnc6wOXBs--7E1Y48yD_ivWH2hyA6QEK8bfLY9yiVPYpB0AJ14ObG8X5sSr4EJ0g79F64lWtE2r7ATzSi76JVndFoWlIdzZIU0jZ7n_mEULOg_j33n6JzyQ0eg</recordid><startdate>20040801</startdate><enddate>20040801</enddate><creator>Hurbanek, Jason G.</creator><creator>Jaffer, Amir K.</creator><creator>Morra, Nariman</creator><creator>Karafa, Matthew</creator><creator>Brotman, Daniel J.</creator><general>Schattauer Verlag für Medizin und Naturwissenschaften</general><general>Schattauer GmbH</general><general>Schattauer</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20040801</creationdate><title>Postmenopausal hormone replacement and venous thromboembolism following hip and knee arthroplasty</title><author>Hurbanek, Jason G. ; Jaffer, Amir K. ; Morra, Nariman ; Karafa, Matthew ; Brotman, Daniel J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c543t-631d7fc001ca19bc399dff16256e12d567c19e291e89744baeaffb70714906ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Blood Coagulation, Fibrinolysis and Cellular Haemostasis</topic><topic>Blood coagulation. Blood cells</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hormone Replacement Therapy - adverse effects</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Molecular and cellular biology</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Platelet diseases and coagulopathies</topic><topic>Postmenopause</topic><topic>Retrospective Studies</topic><topic>Thromboembolism - etiology</topic><topic>Thromboembolism - pathology</topic><topic>Venous Thrombosis - etiology</topic><topic>Venous Thrombosis - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hurbanek, Jason G.</creatorcontrib><creatorcontrib>Jaffer, Amir K.</creatorcontrib><creatorcontrib>Morra, Nariman</creatorcontrib><creatorcontrib>Karafa, Matthew</creatorcontrib><creatorcontrib>Brotman, Daniel J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hurbanek, Jason G.</au><au>Jaffer, Amir K.</au><au>Morra, Nariman</au><au>Karafa, Matthew</au><au>Brotman, Daniel J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postmenopausal hormone replacement and venous thromboembolism following hip and knee arthroplasty</atitle><jtitle>Thrombosis and haemostasis</jtitle><addtitle>Thromb Haemost</addtitle><date>2004-08-01</date><risdate>2004</risdate><volume>92</volume><issue>2</issue><spage>337</spage><epage>343</epage><pages>337-343</pages><issn>0340-6245</issn><eissn>2567-689X</eissn><coden>THHADQ</coden><abstract>Summary
Hormone replacement therapy has been associated with venous thromboembolism. Controversy exists regarding the appropriate management of hormone replacement in the perioperative setting and in other situations – such as acute illness – predisposing to acute venous thromboembolism. We performed a case-control study to determine whether perioperative hormone replacement is associated with venous thromboembolism following hip and knee arthroplasty. 108 patients with postoperative venous thrombosis were matched by age, date and type of surgery, and surgeon with 210 controls without thrombosis. Perioperative hormone replacement use was no more prevalent in patients with postoperative thrombosis than those without. Eighteen (16.7%) women with post-operative thrombosis had taken perioperative hormone replacement compared to 49 (23.3%) of controls: odds ratio = 0.66; (95% CI 0.35–1.18; p=0.17). After multivariate analysis, the adjusted odds ratios were similar. Variables predicting post-operative thrombosis included: prior venous thromboembolism (OR = 2.3; p = 0.02), rheumatologic disease (OR = 2.2; p = 0.03), and absence of pharmacologic antithrombotic prophylaxis (OR = 13.4; p = 0.005). Cases and controls were otherwise similar. Users of hormone replacement were similar to non-users except that they were less likely to have coronary disease (OR 0.34; p = 0.03) or prior thrombosis (OR = 0.28; p = 0.04), and were younger (median age 67 versus 74 years; p <0.0001). We found no association between perioperative hormone replacement and post-operative thrombosis in patients undergoing major orthopaedic surgery. Routine discontinuation of these medications preoperatively – and possibly in other situations predisposing to thrombosis, such as acute medical illness – may be unnecessary in patients receiving appropriate pharmacologic antithrombotic prophylaxis.</abstract><cop>Stuttgart</cop><pub>Schattauer Verlag für Medizin und Naturwissenschaften</pub><pmid>15269830</pmid><doi>10.1160/TH04-03-0165</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute Disease Aged Arthroplasty, Replacement, Knee - adverse effects Biological and medical sciences Blood Coagulation, Fibrinolysis and Cellular Haemostasis Blood coagulation. Blood cells Case-Control Studies Female Fundamental and applied biological sciences. Psychology Hematologic and hematopoietic diseases Hormone Replacement Therapy - adverse effects Humans Medical sciences Middle Aged Molecular and cellular biology Multivariate Analysis Odds Ratio Platelet diseases and coagulopathies Postmenopause Retrospective Studies Thromboembolism - etiology Thromboembolism - pathology Venous Thrombosis - etiology Venous Thrombosis - pathology |
| title | Postmenopausal hormone replacement and venous thromboembolism following hip and knee arthroplasty |
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