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Proton pump inhibitors may help mitigate GI bleed risk after THR
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A patient’s risk of gastrointestinal bleeding is elevated for 2 weeks after total hip replacement or total knee replacement and persisted up to 12 weeks in patients who underwent total hip replacement, according to results of a nationwide Danish cohort study.
“The increase in [gastrointestinal] GI bleeding risk was not influenced by current outpatient antithrombotic drug use, and [proton pump inhibitors] PPIs lowered the 6-week risk of GI bleeding following [total hip replacement] THR, regardless of concomitant NSAID use,” Frank de Vries, PharmD, PhD, and colleagues wrote in their study. “These results emphasize the importance of GI bleeding risk assessment, fine-tuning in-hospital antithrombotic therapy, and the potential benefit of prescribing PPIs.”
De Vries and colleagues analyzed records for 95,115 patients in Denmark who underwent THR or total knee replacement (TKR) between 1998 and 2007 who were matched to controls not undergoing surgery by age, gender and region of the country. They found a six-fold increase in GI bleeding in THR patients and a more than 2.3-fold increase in GI bleeding in TKR patients within the 2 weeks of surgery compared to controls.
While the TKR patients’ risk for GI bleeding persisted for 6 weeks, the risk of bleeds in THR patients remained elevated until 12 weeks postoperatively, according to the abstract.
Disclosure: The study was funded by The Netherlands Organization for Scientific Research.
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