{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T15:46:35Z","timestamp":1763307995234,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,7,31]],"date-time":"2017-07-31T00:00:00Z","timestamp":1501459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life\u2010threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data. Previously calculated health utility values were obtained from published studies for both thrombotic events and anticoagulant\u2010related complications at the site of arthroplasty. An impact score was generated through a multiplication of 1 \u2212 utility with the rate of the event occurring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Impact scores associated with revision surgery and deep infection at the arthroplasty site following anticoagulation are higher compared to impact scores in subsets of non\u2010treated venous thromboembolism, low <jats:styled-content style=\"fixed-case\">CHADS2<\/jats:styled-content> (congestive heart failure, hypertension, age &gt;75, diabetes (1 point each), stroke\/transient ischaemic attack (2 points)) atrial fibrillation and potentially some acute coronary syndrome patients. Some anticoagulation strategies in mechanical heart valves are of definite overall patient value due to the significant complications otherwise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Objective calculation of both the benefit and risks of anticoagulation in the post\u2010operative patient is significantly altered by including the effect on patient's quality of life utility value. Therapeutic anticoagulation in some common situations is probable to be of more detriment than benefit when considering health utility.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14122","type":"journal-article","created":{"date-parts":[[2017,7,31]],"date-time":"2017-07-31T23:53:02Z","timestamp":1501545182000},"page":"820-824","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of health utility after thrombotic complications following total hip and knee arthroplasty"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2415-6718","authenticated-orcid":false,"given":"Bikram","family":"Karmakar","sequence":"first","affiliation":[{"name":"Department of Orthopaedics John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/230949900801600115"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.50.2.182"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2011.03.033"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.06.001"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.11.003"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2306-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200301000-00005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00373"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.063"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr488"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-010-9591-y"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a9f45f"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.07.023"},{"key":"e_1_2_6_16_1","first-page":"CD003462","article-title":"Heparin versus placebo for non\u2010ST elevation acute coronary syndromes","author":"Andrade\u2010Castellanos C","year":"2014","journal-title":"Cochrane Database Syst. 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