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Patients taking warfarin after TJA may experience higher rates of readmission, complications
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Researchers found a supratherapeutic international normalized ratio level when being discharged after total joint arthroplasty was associated with a higher rate of readmission and higher number of complications in patients taking warfarin, according to results of this study.
“Frequent [international normalized ratio] INR monitoring, early patient discharge at subtherapeutic levels, a high rate of postoperative complications and increased readmission rates were shown in this study to all be concerns with using warfarin as [venous thromboembolism] VTE prophylaxis in joint arthroplasty,” Michael Ayndardi, MD, and colleagues from The Rothman Institute at Jefferson University in Philadelphia, wrote in the study.
They added, “Given these findings we call into question the safety of continued use of warfarin for routine VTE prophylaxis in modern [total joint arthroplasty] TJA patients where there is a trend toward shorter length of stay.”
Aynardi and colleagues examined INR rates at discharge, readmissions and complications of 441 patients who underwent TJA from 2010 to 2011, according to the abstract. They found a 15% complication rate and an 8.6% readmission rate in these patients, noting 80% of patients had a subtherapeutic INR at discharge.
Disclosure: One of the authors (Orozco) is a paid consultant for, receives stock options from and receives royalties from Stryker. One of the authors (Ong) is a paid consultant for, receives stock options from and receives royalties from Stryker and Smith & Nephew.
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