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Thromboprophylaxis after Arthroplasty
J. Kor. Soc. Health-syst. Pharm. 2019;36:10-25
Published online February 28, 2019;  https://doi.org/10.32429/jkshp.2019.36.1.001
© 2019 Korean Society of Health-System Pharmacists

Yeon Hee Kima,b and Nam Kyung Jea,†

College of Pharmacy, Pusan National University, 2, Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241, Republic of Koreaa, Department of Pharmacy, Busan Veterans Hospital, 420, Baegyang-daero, Sasang-gu, Busan, 46996, Republic of Koreab
Correspondence to: 제남경 Tel:051-510-2802 E-mail:jenk@pusan.ac.kr
Received August 6, 2018; Revised September 3, 2018; Accepted December 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : Antithrombotic prophylaxis is recommended after knee and hip arthroplasty to prevent venous thromboembolism. The purpose of this study was to investigate the current trend of thromboprophylaxis after knee and hip arthroplasty in South Korea.
Methods : We analyzed Aged Patient Sample data from 2016 compiled by the Health Insurance Review & Assessment Service (HIRA-APS-2016), to estimate the rate of pharmacological thromboprophylaxis. We also examined the factors influencing the utilization of thromboprophylaxis, according to patient and institutional characteristics.
Results : Thirty-seven percent of patients underwent thromboprophylaxis after knee and hip arthroplasty. The most utilized antithrombotic agent was rivaroxaban (67.4%), followed by enoxaparin (16.1%). In terms of population characteristics, factors such as older age, male gender, health insurance type (Medical Aid/Veterans), and comorbidities (peripheral vascular disease and stroke) were identified as risk factors for underuse of thromboprophylaxis.
Conclusions : Less than half of the post-knee and hip arthroplasty patients received thromboprophylaxis. The use of non-vitamin K oral anticoagulants to replace conventional low molecular weight heparin and warfarin has increased.
Keywords : Arthroplasty, Low molecular weight heparin, Non-vitamin K oral anticoagulants, Rivaroxaban, Thromboprophylaxis