Perioperative changes in coagulation function after total knee or hip arthroplasty measured by rapid thromboelastometry

Objective To study the changes in coagulation function after total knee or hip arthroplasty by rapid thromboelastometry and to provide guidance for perioperative anticoagulation. Methods Patients undergoing total knee or hip arthroplasty at Peking Union Medical College Hospital between June,2014 to July,2014 were enrolled. Information included sex,age,height,weight,total intraoperative blood loss and total postoperative drainage volume were collected. Blood samples were collected for rapid thromboelastometry at three time points: before surgery,the end of the surgery and 24 hours after the surgery. Results 54 patients were enrolled. For patients undergoing total knee replacement,K value increased,αangle and MA value decreased at 24 hours after the surgery( P 0. 05 when compared to those before surgery). For patients undergoing total hip replacement,K value increased,αangle and MA value decreased at the end of surgery( P 0. 05 when compared to those before surgery). K value,αangle and MA value returned to basal level at 24 hours after the surgery( P 0. 05 when compared to those before surgery). There were no significant changes for LY30 and R value for patients at both groups. Conclusion Different surgeries have different effects on patients' coagulation functions. Rapid thromboelastometry is sensitive to detect changes in coagulation and provide evidence to guide anticoagulant therapy.