Thrombelastogram for evaluating perioperative blood clot changes in patients received rivaroxaban anticoagulation after hip revision surgery

Abstract:

Objective：To assess the coagulation function changes by using thrombelastogram（TEG） in patients receiving rivaroxaban anticoagulation after hip revision surgery. Methods：Data of 75 patients underwent hip revision from April 2014 to December 2017 were reviewed. All patients took rivaroxaban of 10 mg within 12 hours after surgery to prevent thrombus with the frequency of once a day. All patients received TEG determination before surgery and on the 1st，3nd，5th and 7th day after surgery. Changes of TEG pa－rameters and proportional difference of hypercoagulable states at different time were compared. Results：Reaction time（R） on the 1st，3nd，5th and 7th day after surgery was decreased than that before surgery，with statistically significant difference. Mean clot index （CI） on the 1st，3nd，5th and 7th day after surgery was increased than that before surgery，with statistically significant difference. Mean maximum amplitude（MA） on the 5th and 7th day after surgery was increased than that before surgery，with statistically significant dif－ference. A total of 34.67% patients had hypercoagulable states on the 7th day，with the main of mixed hypercoagulability. Conclusion：The conventional dose of rivaroxaban is used for anticoagulation after hip revision，but the patient is still in a hypercoagulable state，with the main of mixed hypercoagulability. The existing thromboprophylaxis program after hip revision may be not perfect，therefore，exploring the individualized anticoagulation program is the future research direction.