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Impact of Surgical Injury on Haemostatic Tests in Patients Undergoing Total Hip Replacement With Subgroup Analysis of Patients With Neoplasm

Recruiting
Conditions
Thromboelastometry
Total Hip Replacement
Bone Neoplasm of Hip
Interventions
Diagnostic Test: Rotational thromboelastometry
Registration Number
NCT04442373
Lead Sponsor
Medical University of Warsaw
Brief Summary

Total hip replacement (THR) is associated with extensive tissue injury and considerable blood loss that can be complicated by hyperfibrinolysis with an increased need for blood transfusion. THR in patients with cancer involving the hip joint, can reduce pain and improve or maintain the function and quality of life. However, these patients have an increased likelihood of haemostatic abnormalities, such as thrombosis or extensive blood loss. Rotational thromboelastometry is a point-of-care viscoelastic assay that can provide a measure of coagulation disorders in the above settings, and this is still under review. The objective of this prospective cohort study is to quantitate the changes in clot formation dynamics following THR with a subgroup analysis of patients with cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Adult patients undergoing primary elective total hip replacement
Exclusion Criteria
  • Patients unable to consent to trial
  • Active deep and superficial vein thrombosis
  • Coagulopathy in initial coagulation screen tests
  • Platelet count below 100 thousand
  • Patients on antithrombotic medications (except prophylactic low molecular weight heparins and acetylsalicylic acid up to 75 mg per day)
  • Preoperative haemoglobin < 10 g/dl
  • Female patients who are pregnant or nursing

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients undergoing THR with known bone neoplasmRotational thromboelastometryPre- and postoperative blood sampling for ROTEM assessment before and after THR in patients with bone neoplasm
Patients undergoing THR with no known bone neoplasmRotational thromboelastometryPre- and postoperative blood sampling for ROTEM assessment in THR patients
Primary Outcome Measures
NameTimeMethod
INTEM parameters change from preoperative to postoperative values30 minutes before and 30 minutes after surgery
EXTEM parameters change from preoperative to postoperative values30 minutes before and 30 minutes after surgery
FIBTEM parameter change from preoperative to postoperative values30 minutes before and 30 minutes after surgery
Secondary Outcome Measures
NameTimeMethod
Total volume of infused fluidsFrom first fluid on day of surgery to end of surgery, an average of 12 hours

Crystalloids, blood products

Pre- and postoperative haemoglobin and haematocritFrom day before surgery to postoperative day 3
Intraoperative blood lossBlood loss as measured during surgery

Amount of blood loss in millilitres

Hip Disability and Osteoarthritis Outcome Score (HOOS)The day before surgery and at 6 ± 1 months, 12 ± 1 month after surgery

Instrument for measuring outcome following surgery with higher scores representing better function. Score from 0 to 100.

The 36-Item Short Form Health Survey (SF-36)The day before surgery and at 6 ± 1 months, 12 ± 1 month after surgery

Health related Quality of Life measure. Higher score indicates better health state with eight scaled scores each from 0 to 100.

Visual Analogue Scale (VAS) scoreThe day before surgery and at 6 ± 1 months, 12 ± 1 month after surgery

The ends of the scale are defined as the extreme limits of the pain. Orientated from the left (no pain) to the right (worst imaginable pain) measured in millimeters from 0 to 100.

Trial Locations

Locations (1)

I Department of Anesthesiology and Intensive Care Warsaw Medical University

🇵🇱

Warsaw, Mazowieckie, Poland

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