71.
The association between use of serotonergic antidepressants and
perioperative bleeding during hip replacement
Annie Primdahl, Frank Damborg, Michael Dall, Jesper Hallas
Department of Orthopaedic Surgery Esbjerg; Department of Orthopaedic
Surgery, Kolding; Research Unit of Clinical Pharmacology, University of
Southern Denmark, Odense; Research Unit of Clinical Pharmacology,
University of Southern Denmark, Odense
Background:
In vitro studies have shown that selective serotonin reuptake
inhibitors (SSRIs) inhibit platelet aggregation. It is controversial whether use
of SSRIs can cause clinically important bleedings; results from observational
studies have been equivocal.
Purpose / Aim of Study:
Our objective was to determine a possible
association between use of serotonergic antidepressants and intraoperative
bleeding during hip replacements.
Materials and Methods:
We conducted a retrospective study among patients
that underwent a primary unilateral uncemented total hip arthroplasty (THA)
in the Region of Southern Denmark between 1 January 2007 and 28 February
2011.
Information was collected on blood loss and the need for transfusions in
this group. We compared the blood loss between users of serotonergic
antidepressants, users of nonserotonergic antidepressants and non-users. Data
on drug exposure were retrieved from the Odense Pharmacoepidemiological
Database (OPED). Adjustment for drug-related confounders was carried out by
linear regression.
Findings / Results:
We indentified 638 patients that underwent a THA in the
study period. The adjusted difference in blood loss among respectively, users
of serotonergic antidepressants and non- serotonergic antidepressants were
62.2
ml (95% CI, -10.1 – 147.5) and 22.9 ml (95% CI, -101.6 – 147.5)
compared with non-use.
Conclusions:
Use of serotonergic antidepressants was associated with a non-
significant increased blood loss compared to non- users.
