인공관절 치환술 환자에서 Rivaroxaban의 심부정맥혈전증 예방효능

초록

Venous thromboembolism (VTE) is a serious complication after major orthopedic surgery. Our aim was to compare the thromboprophylactic efficacy of rivaroxaban (RXB) with a previously known prevalence of VTE without chemical prophylaxis in Asian arthroplasty patients. A total of 491 patients who underwent an elective knee or hip arthroplasty between 2010 and 2013 were evaluated, retrospectively. Patients received oral RXB 10mg once daily for 5-13 days, from the day after hemovac drainage removal to the postoperative 14th day. The efficacy outcome was prevalence of VTE or pulmonary embolism (PE), and occurrence of death during the follow-up period. The incidence of VTE was 1.43% (n=7). Of them, 0.41% (n=2) were diagnosed with a PE. Compared to our previous data, 1.99% of the VTEs and 0.24% of PEs without chemical prophylaxis, the relative risk (RR) of VTE was 0.72 and RR of PE was 1.71. No deaths during the follow-up period were observed. On-treatment bleeding had occurred in 2 cases. One case was an upper gastrointestinal bleed and the other was a retroperitoneal hemorrhage. According to these results, 10mg once daily RXB in Asian arthroplasty patients has had a valuable thromboprophylactic efficacy. However, close observation is required due to complications such as on-treatment bleeding.