None listed
Conditions
Brief summary
This primary aim of this study is to determine if preoperative hypercoagulability, identified by ROTEM analysis, can predict postoperative thrombotic complications in overweight and obese patients undergoing elective lower limb joint replacements. Secondary aims: 1. To develop clinical threshold with ROTEM parameters to identify high risk patients with increased body mass index and/or waist circumference. 2. To monitor coagulation changes with ROTEM assays and platelet function with Multiplate analyser, preoperatively and postoperatively, in this cohort of patients. 3. To assess the sensitivity of the ROTEM assay to predict high-risk patients stratified according to body mass index and waist circumference.
Interventions
Preoperative and postopeartive ROTEM assays will be used detect hypercoagulability defined by the presence of rapid clot formation (evidenced by a shortened clotting time or clot formation time, increased alph angle) and/or increased clot strength (evidenced by high maximum clot firmness) in whole blood. Blood will be collected in a 3.5 mL citrated tube and 3 mL hirudin tube for ROTEM and multiplate analysis, respectively. These samples will be taken immediately prior to surgery, in the immediat
Preoperative and postopeartive ROTEM assays will be used detect hypercoagulability defined by the presence of rapid clot formation (evidenced by a shortened clotting time or clot formation time, increased alph angle) and/or increased clot strength (evidenced by high maximum clot firmness) in whole blood. Blood will be collected in a 3.5 mL citrated tube and 3 mL hirudin tube for ROTEM and multiplate analysis, respectively. These samples will be taken immediately prior to surgery, in the immediate post-operative period, and on days 1 and 3 post-operatively. The results of the ROTEM and multiplate investigations will not alter patient treatment. Patients will be commenced onThe Prince Charles Hospital venous thromboembolic prophylactic pathway which involves TED stockings, sequential compression devices, and either anticoagulants or aspirin
Sponsors
The Prince Charles Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All patients undergoing elective primary hip or knee replacement surgery with a BMI greater than/equal to 25 kg/m2 or waist circumference greater than/equal to 94 cm for males or 80 cm for females.
Exclusion criteria
1) Known history of thrombophilia (2) other possible causes of hypercoagulability namely active malignancy, prolonged bed rest, oral contraceptive pills, hormone replacement therapy, previous history of VTE and nephrotic syndrome (3) other disorders that would require postoperative anticoagulation such as cardiac valves/patients on long-term anticoagulation.
Outcome results
None listed