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The Association between Use of Serotonergic Antidepressants and Perioperative Bleeding during Total Hip Arthroplasty – A Cohort Study
Author(s) -
Dall Michael,
Primdahl Annie,
Damborg Frank,
Nymark Tine,
Hallas Jesper
Publication year - 2014
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12218
Subject(s) - medicine , perioperative , confounding , serotonergic , confidence interval , retrospective cohort study , anesthesia , cohort study , surgery , serotonin , receptor
In vitro studies have shown that selective serotonin reuptake inhibitors inhibit platelet aggregation. It is well documented that SSRI s cause serious gastrointestinal bleeding, but studies on other bleeding manifestations have been equivocal. Our objective was to determine a possible association between use of serotonergic antidepressants ( SA ) and perioperative bleeding during hip replacements. We conducted a retrospective study between 1 January 2007 and 30 June 2012 among patients that underwent a primary unilateral uncemented total hip arthroplasty ( THA ). Information was collected on the observed blood loss and the need for blood transfusions among this group. We compared the blood loss between users of SA , users of non‐serotonergic antidepressants ( NSA ) and non‐users, while adjusting for potential confounders using multivariate linear regression. We indentified 1318 patients that underwent a THA in the study period. The average volume of surgical bleeding was 350 ml. The adjusted incremental blood loss associated with use of SA and NSA was 93, 95% confidence interval (38–147) ml and −50 (−125 to 25) ml compared with non‐use. Only 48 subjects (3.6%) had transfusions. Use of SA was associated with an increased blood loss compared with non‐users. The hypothesis that SA impairs haemostasis is supported by these results.