 |
|
Relationship of Serotonergic Antidepressants and Need for Blood Transfusion in Orthopedic Surgical Patients
Kris L. L. Movig, PhD;
Michiel W. H. E. Janssen, MD;
Jan de Waal Malefijt, MD, PhD;
Peter J. Kabel, MD, PhD;
Hubert G. M. Leufkens, PhD;
Antoine C. G. Egberts, PhD
Arch Intern Med. 2003;163:2354-2358.
Background Several reports of various bleeding problems associated with the use of serotonergic antidepressants have been published. However, no information concerning the effect of these drugs on perioperative blood loss and blood transfusion requirements during orthopedic surgery is available. The objective of this study was to determine the association between use of serotonergic antidepressants and perioperative blood loss and transfusion in orthopedic surgical patients.
Methods A retrospective follow-up study, using routinely collected hospital and pharmacy data, was conducted among all orthopedic patients undergoing surgery from January 1, 1999, through December 31, 2000. The actual blood transfusion requirements and blood loss during surgery were assessed. Patients were divided into 3 groups for comparison: users of serotonergic antidepressants, users of nonserotonergic antidepressants, and nonusers of antidepressants. The Medical Ethics Committee approved the study protocol, and informed consent was obtained from all patients or their legal relatives.
Results A total of 520 subjects with evaluable data participated in the study. The risk of blood transfusion almost quadrupled for the serotonergic antidepressant group as compared with the nonusers (adjusted odds ratio, 3.71; 95% confidence interval, 1.35-10.18). Patients using nonserotonergic antidepressants had no increased risk (odds ratio, 0.74; 95% confidence interval, 0.10-5.95).
Conclusions Use of serotonergic antidepressants is associated with an increased risk of bleeding and subsequent need for blood transfusion during orthopedic surgery. The bleeding could be attributed to inhibition of serotonin-mediated platelet activation.
From the Hospital Pharmacy Midden-Brabant, St Elisabeth Hospital and TweeSteden Hospital, Tilburg, the Netherlands (Drs Movig and Egberts); Departments of Orthopaedic Surgery (Drs Janssen and de Waal Malefijt) and Medical Microbiology (Dr Kabel), St Elisabeth Hospital, Tilburg; and Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands (Drs Movig, Leufkens, and Egberts). The authors have no relevant financial interest in this article.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Risk of Upper Gastrointestinal Tract Bleeding Associated With Selective Serotonin Reuptake Inhibitors and Venlafaxine Therapy: Interaction With Nonsteroidal Anti-inflammatory Drugs and Effect of Acid-Suppressing Agents
de Abajo and Garcia-Rodriguez
Arch Gen Psychiatry 2008;65:795-803.
ABSTRACT
| FULL TEXT
Potential Medical and Surgical Complications of Serotonergic Antidepressant Medications
Looper
Psychosomatics 2007;48:1-9.
ABSTRACT
| FULL TEXT
SSRIs and gastrointestinal bleeding
Paton and Ferrier
BMJ 2005;331:529-530.
FULL TEXT
General population based study of the impact of tricyclic and selective serotonin reuptake inhibitor antidepressants on the risk of acute myocardial infarction
Tata et al.
Heart 2005;91:465-471.
ABSTRACT
| FULL TEXT
Association of Risk of Abnormal Bleeding With Degree of Serotonin Reuptake Inhibition by Antidepressants
Meijer et al.
Arch Intern Med 2004;164:2367-2370.
ABSTRACT
| FULL TEXT
Excess Bleeding After Surgery Found In Patients Taking SSRIs
Rosack
Psychiatr. News 2003;38:13-13.
FULL TEXT
|
