# Risk Factors for Anemia Exacerbation Requiring Red Blood Cell Transfusion During Edoxaban Thromboprophylaxis After Orthopedic Surgery

## TL;DR

This study identifies risk factors for anemia requiring blood transfusion during edoxaban use after orthopedic surgery.

## Contribution

The study identifies preoperative hemoglobin levels and intraoperative blood loss as risk factors for transfusion during edoxaban thromboprophylaxis.

## Key findings

- Lower preoperative hemoglobin levels increase the likelihood of transfusion during edoxaban use.
- Higher intraoperative blood loss per body weight is significantly associated with more frequent transfusions.
- These factors are linked to increased coagulation parameters during edoxaban thromboprophylaxis.

## Abstract

Background

An increased risk of anemia during edoxaban thromboprophylaxis in orthopedic surgery has been reported. However, the risk factors for the exacerbation of anemia requiring transfusion with irradiated red blood cell concentrates during postoperative edoxaban thromboprophylaxis remain unknown. Therefore, this study investigated the factors that increase the possibility of transfusion during edoxaban thromboprophylaxis after orthopedic surgery by reanalyzing clinical data from a previous collection.

Methods

A total of 221 patients who underwent total hip or knee arthroplasty at a single center between July 2011 and June 2012 were included in this study. Among these, 167 patients who received 30 mg of postoperative edoxaban thromboprophylaxis were retrospectively analyzed to identify critical factors for transfusion during edoxaban thromboprophylaxis after orthopedic surgery.

Results

Lower preoperative hemoglobin levels and higher intraoperative blood loss per body weight were significantly associated with an increase in the frequency of transfusion during postoperative edoxaban thromboprophylaxis. These factors were also potentially related to increased coagulation parameters during edoxaban thromboprophylaxis.

Conclusion

Our study shows that lower preoperative hemoglobin levels and higher intraoperative blood loss are associated with increased coagulation parameters with edoxaban thromboprophylaxis after orthopedic surgery and may lead to worsening of anemia, thereby requiring blood transfusion.