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Article: Incidences of steroid-induced diabetes mellitus and congestive heart failure in cats given non-immunosuppressive doses of methylprednisolone acetate: 1042 cats.

Dutch, Wendy A / Norsworthy, Gary D / Mayfield, Milton R / Mayfield, Jacqueline R / Schmitt, Connie W

The Canadian veterinary journal = La revue veterinaire canadienne

2023 Volume 64, Issue 11, Page(s) 1051–1057

Abstract: Objective: Corticosteroids are indicated to treat many feline diseases. However, side effects are a limiting factor in their use. The most concerning side effects are steroid-induced diabetes mellitus (SI-DM) and steroid-induced congestive heart failure ...

Abstract	Objective: Corticosteroids are indicated to treat many feline diseases. However, side effects are a limiting factor in their use. The most concerning side effects are steroid-induced diabetes mellitus (SI-DM) and steroid-induced congestive heart failure (SI-CHF). This study aims to determine the incidences of these diseases in a large population of domestic cats seen at a privately-owned, feline-only practice. Animals: Cats in the study were client-owned patients of Alamo Feline Health Center in San Antonio, Texas. Control cats (controls) were examined as part of their routine health care. Procedures: The records of 732 cats that received methylprednisolone acetate (MPA) for various clinical indications were reviewed to determine how many developed SI-DM and SI-CHF. A similar record review of 310 controls was made to determine the incidence of spontaneous diabetes mellitus (Sp-DM) and spontaneous congestive heart failure (Sp-CHF). Control cats never received any oral or injectable corticosteroids. Results: Of the cats that received MPA, 28 developed SI-DM (3.83%) and 6 developed SI-CHF (0.82%). Of the controls, 22 developed Sp-DM (7.10%) and 6 developed Sp-CHF (1.90%). Conclusion: The incidences of developing SI-DM and SI-CHF were 3.83% and 0.82%, respectively; and the risk was not increased even when repeated doses of MPA were given. Clinical relevance: The authors consider the risk-benefit ratio sufficient to justify the use of MPA when it is indicated, especially if another drug cannot be substituted with the same therapeutic results.
MeSH term(s)	Cats ; Animals ; Methylprednisolone Acetate ; Incidence ; Heart Failure/chemically induced ; Heart Failure/epidemiology ; Heart Failure/veterinary ; Diabetes Mellitus/veterinary ; Adrenal Cortex Hormones ; Cat Diseases/chemically induced ; Cat Diseases/epidemiology
Chemical Substances	Methylprednisolone Acetate (43502P7F0P) ; Adrenal Cortex Hormones
Language	English
Publishing date	2023-11-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	41603-4
ISSN	0008-5286
ISSN	0008-5286
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Article ; Online: Medical Weight Optimization for Arthroplasty Patients: A Primer of Emerging Therapies for the Joint Arthroplasty Surgeon.

Mayfield, Cory K / Mont, Michael A / Lieberman, Jay R / Heckmann, Nathanael D

The Journal of arthroplasty

2023 Volume 39, Issue 1, Page(s) 38–43

Abstract: The obesity epidemic in the United States continues to grow with more than 40% of individuals now classified as obese (body mass index >30). Obesity has been readily demonstrated to increase the risk of developing hip and knee osteoarthritis and is known ...

Abstract	The obesity epidemic in the United States continues to grow with more than 40% of individuals now classified as obese (body mass index >30). Obesity has been readily demonstrated to increase the risk of developing hip and knee osteoarthritis and is known to increase the risk of complications following joint arthroplasty. Weight loss prior to arthroplasty may mitigate this risk of complications; however, the existing evidence remains mixed with no clear consensus on the optimal method of weight loss and timing prior to arthroplasty. Treatment options for weight loss have included nonsurgical lifestyle modifications consisting of structured diet, physical activity, and behavioral modification, as well as bariatric and metabolic surgery (ie, sleeve gastrectomy, Roux-en-Y gastric bypass, and the adjustable gastric band). Recently, glucagon-like peptide-1 receptor agonists have gained notable popularity within the scientific literature and media for their efficacy in weight loss. The aim of this review is to provide a foundational primer for joint arthroplasty surgeons regarding the current and emerging options for weight loss to aid surgeons in shared decision-making with patients prior to arthroplasty.
MeSH term(s)	Humans ; United States ; Obesity, Morbid/complications ; Osteoarthritis, Hip/surgery ; Laparoscopy ; Osteoarthritis, Knee/surgery ; Osteoarthritis, Knee/complications ; Obesity/complications ; Obesity/surgery ; Bariatric Surgery/adverse effects ; Weight Loss ; Surgeons ; Treatment Outcome
Language	English
Publishing date	2023-07-31
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.07.017
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Article ; Online: Knockdown of Tlr3 in dorsal striatum reduces ethanol consumption and acute functional tolerance in male mice.

Dilly, Geoffrey A / Blednov, Yuri A / Warden, Anna S / Ezerskiy, Lubov / Fleischer, Caleb / Plotkin, Jesse D / Patil, Shruti / Osterndorff-Kahanek, Elizabeth A / Mayfield, Jody / Mayfield, R Dayne / Homanics, Gregg E / Messing, Robert O

Brain, behavior, and immunity

2024 Volume 118, Page(s) 437–448

Abstract: Systemic activation of toll-like receptor 3 (TLR3) signaling using poly(I:C), a TLR3 agonist, drives ethanol consumption in several rodent models, while global knockout of Tlr3 reduces drinking in C57BL/6J male mice. To determine if brain TLR3 pathways ... ...

Abstract	Systemic activation of toll-like receptor 3 (TLR3) signaling using poly(I:C), a TLR3 agonist, drives ethanol consumption in several rodent models, while global knockout of Tlr3 reduces drinking in C57BL/6J male mice. To determine if brain TLR3 pathways are involved in drinking behavior, we used CRISPR/Cas9 genome editing to generate a Tlr3 floxed (Tlr3
MeSH term(s)	Mice ; Male ; Animals ; Toll-Like Receptor 3/metabolism ; Mice, Inbred C57BL ; Ethanol/pharmacology ; Signal Transduction ; Alcohol Drinking/metabolism ; Poly I-C/pharmacology
Chemical Substances	Toll-Like Receptor 3 ; Ethanol (3K9958V90M) ; Poly I-C (O84C90HH2L)
Language	English
Publishing date	2024-03-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	639219-2
ISSN	1090-2139 ; 0889-1591
ISSN (online)	1090-2139
ISSN	0889-1591
DOI	10.1016/j.bbi.2024.03.021
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Zs.A 2276: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Mutation of novel ethanol-responsive lncRNA Gm41261 impacts ethanol-related behavioral responses in mice.

Plasil, S L / Farris, S P / Blednov, Y / Mayfield, R D / Mangieri, R A / Nwokeji, U J / Aziz, H C / Lambeth, P S / Harris, R A / Homanics, G E

Genes, brain, and behavior

2024 Volume 23, Issue 1, Page(s) e12886

Abstract: Chronic alcohol exposure results in widespread dysregulation of gene expression that contributes to the pathogenesis of Alcohol Use Disorder (AUD). Long noncoding RNAs are key regulators of the transcriptome that we hypothesize coordinate alcohol-induced ...

Abstract	Chronic alcohol exposure results in widespread dysregulation of gene expression that contributes to the pathogenesis of Alcohol Use Disorder (AUD). Long noncoding RNAs are key regulators of the transcriptome that we hypothesize coordinate alcohol-induced transcriptome dysregulation and contribute to AUD. Based on RNA-Sequencing data of human prefrontal cortex, basolateral amygdala and nucleus accumbens of AUD versus non-AUD brain, the human LINC01265 and its predicted murine homolog Gm41261 (i.e., TX2) were selected for functional interrogation. We tested the hypothesis that TX2 contributes to ethanol drinking and behavioral responses to ethanol. CRISPR/Cas9 mutagenesis was used to create a TX2 mutant mouse line in which 306 base-pairs were deleted from the locus. RNA analysis revealed that an abnormal TX2 transcript was produced at an unchanged level in mutant animals. Behaviorally, mutant mice had reduced ethanol, gaboxadol and zolpidem-induced loss of the righting response and reduced tolerance to ethanol in both sexes. In addition, a male-specific reduction in two-bottle choice every-other-day ethanol drinking was observed. Male TX2 mutants exhibited evidence of enhanced GABA release and altered GABA
MeSH term(s)	Humans ; Female ; Mice ; Male ; Animals ; Ethanol/toxicity ; RNA, Long Noncoding/genetics ; Alcoholism/genetics ; Alcohol Drinking/genetics ; Receptors, GABA-A/genetics ; Mutation ; Mice, Inbred C57BL
Chemical Substances	Ethanol (3K9958V90M) ; RNA, Long Noncoding ; Receptors, GABA-A
Language	English
Publishing date	2024-02-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2075819-4
ISSN	1601-183X ; 1601-1848
ISSN (online)	1601-183X
ISSN	1601-1848
DOI	10.1111/gbb.12886
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Zs.A 5642: Show issues

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Article ; Online: Aspirin for Venous Thromboembolic Prophylaxis Following Total Hip and Total Knee Arthroplasty: An Analysis of Safety and Efficacy Accounting for Surgeon Selection Bias.

Heckmann, Nathanael D / Piple, Amit S / Wang, Jennifer C / Richardson, Mary K / Mayfield, Cory K / Oakes, Daniel A / Christ, Alexander B / Lieberman, Jay R

The Journal of arthroplasty

2023 Volume 38, Issue 7 Suppl 2, Page(s) S412–S419.e1

Abstract: Background: Aspirin may be effective at preventing venous thromboembolism following total knee arthroplasty (TKA) or total hip arthroplasty (THA). Current evidence is limited by bias as many surgeons who use aspirin prescribe for high-risk patients ... ...

Abstract	Background: Aspirin may be effective at preventing venous thromboembolism following total knee arthroplasty (TKA) or total hip arthroplasty (THA). Current evidence is limited by bias as many surgeons who use aspirin prescribe for high-risk patients alternative chemoprophylactic agents. Therefore, this study aimed to evaluate the risk of pulmonary embolism (PE) and deep vein thrombosis (DVT) in patients who received aspirin and warfarin while accounting for surgeon selection bias. Methods: A national database was queried for patients undergoing primary elective TKA or THA from 2015 to 2020. Patients whose surgeon used aspirin in >90% of their patients were compared to patients whose surgeon used warfarin in >90% of cases. Instrumental variable analyses were performed to assess for PE, DVT, and transfusion while accounting for selection bias. Among TKA patients, 26,657 (18.8%) were in the warfarin cohort and 115,005 (81.2%) were in the aspirin cohort. Among THA patients, 13,035 (17.7%) were in the warfarin cohort and 60,726 (82.3%) were in the aspirin cohort. Results: Analyses were unable to identify a difference in the risk of PE (TKA: adjusted odds ratio [aOR]: 0.98, P = .659; THA: aOR = 0.93, P = .310) and DVT (TKA: aOR = 1.05, P = .188; THA: aOR = 0.96, P = .493) between the aspirin and warfarin cohorts. However, the aspirin cohort was associated with a lower risk of transfusion (TKA: aOR = 0.58, P < .001, THA: 0.84, P < .001). Discussion: After accounting for surgeon selection bias, aspirin was as effective as warfarin at preventing PE and DVT following TKA and THA. Furthermore, aspirin was associated with a lower risk of transfusion compared to warfarin.
MeSH term(s)	Humans ; Aspirin/therapeutic use ; Warfarin/therapeutic use ; Anticoagulants/therapeutic use ; Arthroplasty, Replacement, Knee/adverse effects ; Selection Bias ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Pulmonary Embolism/prevention & control ; Surgeons ; Arthroplasty, Replacement, Hip/adverse effects
Chemical Substances	Aspirin (R16CO5Y76E) ; Warfarin (5Q7ZVV76EI) ; Anticoagulants
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.02.066
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Article ; Online: Safety and Efficacy of Rivaroxaban in Primary Total Hip and Knee Arthroplasty.

Piple, Amit S / Wang, Jennifer C / Kang, Hyunwoo P / Mills, Emily S / Mayfield, Cory K / Lieberman, Jay R / Christ, Alexander B / Heckmann, Nathanael D

The Journal of arthroplasty

2023 Volume 38, Issue 8, Page(s) 1613–1620.e4

Abstract: Background: An optimal venous thromboembolism prophylaxis agent should balance efficacy and safety. While rivaroxaban provides effective venous thromboembolism prophylaxis after total joint arthroplasty, it may be associated with higher rates of ... ...

Abstract	Background: An optimal venous thromboembolism prophylaxis agent should balance efficacy and safety. While rivaroxaban provides effective venous thromboembolism prophylaxis after total joint arthroplasty, it may be associated with higher rates of bleeding. This study aimed to compare the safety and efficacy of rivaroxaban to aspirin and enoxaparin. Methods: A large national database was queried for patients who underwent elective primary total hip (THA) or total knee arthroplasty (TKA) from January 2015 through December 2020 who received rivaroxaban, aspirin, or enoxaparin. Multivariate analyses were performed to assess the 90-day risk of bleeding and thromboembolic complications. Among TKA patients identified, 86,721 (10.8%) received rivaroxaban, 408,038 (50.8%) received aspirin, and 108,377 (13.5%) received enoxaparin. Among THA patients, 42,469 (9.5%) received rivaroxaban, 242,876 (54.5%) received aspirin, and 59,727 (13.4%) received enoxaparin. Results: After accounting for confounding factors, rivaroxaban was associated with increased risk of transfusion (TKA: adjusted odds ratio [aOR] = 2.58, P < .001; THA: aOR 1.64, P < .001), pulmonary embolism (TKA: aOR = 1.25, P = .007), and deep vein thrombosis (TKA: aOR = 1.13, P = .022) compared to aspirin. Compared to enoxaparin, rivaroxaban was associated with an increased risk of combined bleeding events (TKA: aOR = 1.07, P < .001, THA: aOR = 1.11, P < .001), but decreased risk of combined prothrombotic events (THA: aOR = 0.85, P = .036). Conclusion: Rivaroxaban chemoprophylaxis following TKA and THA was associated with an increased risk of bleeding and prothrombotic complications compared to aspirin and enoxaparin.
MeSH term(s)	Humans ; Rivaroxaban/adverse effects ; Enoxaparin/adverse effects ; Arthroplasty, Replacement, Knee/adverse effects ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Arthroplasty, Replacement, Hip/adverse effects ; Anticoagulants/adverse effects ; Aspirin/adverse effects ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology
Chemical Substances	Rivaroxaban (9NDF7JZ4M3) ; Enoxaparin ; Anticoagulants ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2023-02-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.02.028
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Article ; Online: Same-Day Total Joint Arthroplasty in the United States From 2016 to 2020: The Impact of the Medicare Inpatient Only List and the COVID-19 Pandemic.

Richardson, Mary K / Wier, Julian / Liu, Kevin C / Mayfield, Cory K / Vega, Andrew N / Lieberman, Jay R / Heckmann, Nathanael D

The Journal of arthroplasty

2023 Volume 39, Issue 4, Page(s) 858–863.e2

Abstract: Background: Same-day total hip arthroplasty (THA) and total knee arthroplasty (TKA) continue to gain popularity in the United States. The present study sought to quantify recent same-day outpatient trends taking into consideration the COVID-19 pandemic ... ...

Abstract	Background: Same-day total hip arthroplasty (THA) and total knee arthroplasty (TKA) continue to gain popularity in the United States. The present study sought to quantify recent same-day outpatient trends taking into consideration the COVID-19 pandemic as well as the removal of these procedures from the Medicare inpatient only (IPO) list. Methods: Patients undergoing primary elective TKA and THA were identified using the Nationwide Ambulatory Surgery Sample and the National Inpatient Sample from January 1, 2016, to December 31, 2020. The same-day cohort included Nationwide Ambulatory Surgery Sample and National Inpatient Sample patients with a length of stay = 0 days. The inpatient cohort included patients with length of stay ≥1 day. National estimates were extrapolated using weight functions. Results: From January 2016 to December 2020, the proportion of same-day TKA increased from 1.2 (719) to 62.4% (31,293) and the proportion of same-day THA increased from 2.0 (599) to 54.5% (18,252). Following removal from the Medicare IPO list, same-day TKAs increased from 3.2% (1,895) in December 2017 to 13.8% (9,269) in January 2018, and same-day THAs increased from 10.7% (4,295) in December 2019 to 22.5% (8,708) in January 2020. Between February and March 2020, same-day TKAs increased from 42.4 (26,148) to 44.4% (16,972) and same-day THAs increased from 28.5 (10,729) to 30.2% (7,409). Conclusions: The proportion of same-day TKA and THA dramatically increased following removal from the Medicare IPO list and in response to the COVID-19 pandemic. By December 2020, same-day TKA and THA accounted for >50% of all cases performed in the United States.
MeSH term(s)	Humans ; Aged ; United States/epidemiology ; Medicare ; Inpatients ; Pandemics ; Length of Stay ; Risk Factors ; COVID-19/epidemiology ; Arthroplasty, Replacement, Knee ; Arthroplasty, Replacement, Hip ; Retrospective Studies
Language	English
Publishing date	2023-10-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.10.025
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Article ; Online: Increased Risk of Venous Thromboembolism in Patients with Postoperative Anemia After Total Joint Arthroplasty: Are Transfusions to Blame?

Liu, Kevin C / Piple, Amit S / Richardson, Mary K / Mayer, Lucas W / Mayfield, Cory K / Christ, Alexander B / Lieberman, Jay R / Heckmann, Nathanael D

The Journal of bone and joint surgery. American volume

2023 Volume 105, Issue 17, Page(s) 1354–1361

Abstract: Background: The relationship between anemia and the risk of venous thromboembolism (VTE) following total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains unclear. Red blood cell (RBC) transfusions, which have been shown to have ... ...

Abstract	Background: The relationship between anemia and the risk of venous thromboembolism (VTE) following total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains unclear. Red blood cell (RBC) transfusions, which have been shown to have thrombogenic effects, may explain conflicting data. This study sought to elucidate the relationship between anemia, RBC transfusions, and VTE following total joint arthroplasty (TJA). Methods: Using the International Classification of Diseases, Tenth Revision (ICD-10) and Current Procedural Terminology (CPT) codes, the Premier Healthcare Database was queried for all adults who underwent primary elective THA or TKA from January 2015 to December 2020. Patients were classified into 3 cohorts: those who did not have a diagnosis of anemia and did not receive an RBC transfusion (the control group), those with acute blood loss anemia who did not receive a transfusion (the anemia without transfusion group), and those with acute blood loss anemia who did receive a transfusion (the anemia with transfusion group). The primary outcomes assessed were the 90-day rate and risk of deep vein thrombosis (DVT), pulmonary embolism (PE), and aggregate VTE. Analysis of variance and pairwise comparisons were used to compare groups. Multivariable analyses were performed to account for confounding factors. Results: The 1,290,815 patients identified as having undergone TJA included 1,078,507 control patients (83.6%), 198,233 patients who had anemia without transfusion (15.4%), and 14,075 patients who had anemia and transfusion (1.1%). Age, sex, race, length of hospital stay, and hospital costs were significantly different between the 3 groups. After adjusting for confounding factors, there was no difference between the anemia without transfusion group and the control group with regard to DVT (adjusted odds ratio [OR], 0.97 [95% confidence interval (CI), 0.89 to 1.06]; p = 0.500), PE (adjusted OR, 1.04 [95% CI, 0.92 to 1.18]; p = 0.543), and VTE (adjusted OR, 0.99 [95% CI, 0.92 to 1.06]; p = 0.697). However, patients with anemia and transfusion had an increased risk of PE (adjusted OR, 1.83 [95% CI, 1.34 to 2.51]; p < 0.001) and VTE (adjusted OR, 1.39 [95% CI, 1.14 to 1.70]; p = 0.001) compared with patients in the control group. Conclusions: Patients with acute blood loss anemia who received a transfusion were at increased risk for developing VTE following TJA, whereas patients with anemia who did not receive a transfusion were not. Orthopaedic surgeons need to be aware of the risks of transfusion and individualize the use of transfusions in their patients. Level of evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.
MeSH term(s)	Adult ; Humans ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Risk Factors ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Arthroplasty, Replacement, Knee/adverse effects ; Hemorrhage/etiology ; Arthroplasty, Replacement, Hip/adverse effects ; Anemia/epidemiology ; Anemia/etiology ; Anemia/therapy ; Retrospective Studies
Language	English
Publishing date	2023-07-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.23.00146
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Article ; Online: Tranexamic Acid Is Safe in Patients with a History of Venous Thromboembolism Undergoing Total Joint Arthroplasty.

Richardson, Mary K / Liu, Kevin C / Mayfield, Cory K / Kistler, Natalie M / Lieberman, Jay R / Heckmann, Nathanael D

The Journal of bone and joint surgery. American volume

2023 Volume 106, Issue 1, Page(s) 30–38

Abstract: Background: Tranexamic acid (TXA) is increasingly utilized during total knee arthroplasty (TKA) and total hip arthroplasty (THA) to decrease blood loss; however, there are concerns with regard to potential thromboembolic complications, particularly in ... ...

Abstract	Background: Tranexamic acid (TXA) is increasingly utilized during total knee arthroplasty (TKA) and total hip arthroplasty (THA) to decrease blood loss; however, there are concerns with regard to potential thromboembolic complications, particularly in high-risk patients. This study sought to define a subset of patients at elevated risk for thromboembolic complications following total joint arthroplasty (TJA) and to compare postoperative outcomes between patients who received TXA and those who did not. Methods: Patients who underwent primary, elective TJA from 2015 to 2021 were identified in the Premier Healthcare Database. Patients with a history of venous thromboembolism, defined as a history of pulmonary embolism or deep vein thrombosis, were identified and formed the high-risk cohort. Patient demographic characteristics, hospital factors, patient comorbidities, antithrombotic medication use, perioperative blood transfusion, and 90-day complications were assessed and compared between patients who received TXA and those who did not. Univariate regression and multivariable regression were performed to account for potential confounders. Results: The high-risk cohort comprised 70,759 patients who underwent TJA, of whom 46,074 (65.1%) received TXA and 24,685 (34.9%) did not. After controlling for confounding factors, patients in the TXA cohort had similar risks of pulmonary embolism (adjusted odds ratio [OR], 0.90 [95% confidence interval (CI), 0.79 to 1.02]; p = 0.097), stroke (adjusted OR, 0.97 [95% CI, 0.69 to 1.37]; p = 0.867), and myocardial infarction (adjusted OR, 0.93 [95% CI, 0.69 to 1.24]; p = 0.614) compared with patients who did not receive TXA. Patients who received TXA demonstrated decreased risks of transfusion (adjusted OR, 0.42 [95% CI, 0.38 to 0.46]; p < 0.001) and 90-day readmission (adjusted OR, 0.87 [95% CI, 0.80 to 0.94]; p < 0.001). Conclusions: TXA utilization was not associated with an increased risk of postoperative pulmonary embolism, stroke, or myocardial infarction in patients with a history of venous thromboembolism. Furthermore, patients who received TXA had a decreased risk of transfusion and readmission. This evidence suggests that TXA may be safely utilized among select high-risk patients. Level of evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
MeSH term(s)	Humans ; Tranexamic Acid/adverse effects ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Antifibrinolytic Agents/adverse effects ; Retrospective Studies ; Blood Loss, Surgical ; Arthroplasty, Replacement, Knee/adverse effects ; Arthroplasty, Replacement, Hip/adverse effects ; Pulmonary Embolism/etiology ; Myocardial Infarction/etiology ; Stroke
Chemical Substances	Tranexamic Acid (6T84R30KC1) ; Antifibrinolytic Agents
Language	English
Publishing date	2023-11-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.23.00254
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Article: An Updated Estimate of Total Hip and Total Knee Arthroplasty Inpatient Case Volume During the 2020 COVID-19 Pandemic in the United States.

Heckmann, Nathanael D / Mayfield, Cory K / Richardson, Mary K / Liu, Kevin C / Wang, Jennifer C / Piple, Amit S / Stambough, Jeffrey B / Oakes, Daniel A / Christ, Alexander B / Lieberman, Jay R

Arthroplasty today

2024 Volume 26, Page(s) 101336

Abstract: Background: Inpatient total hip arthroplasty (THA) and total knee arthroplasty (TKA) practices were dramatically affected in the United States in 2020 as elective surgeries were paused in response to the COVID-19 pandemic. This study sought to provide ... ...

Abstract	Background: Inpatient total hip arthroplasty (THA) and total knee arthroplasty (TKA) practices were dramatically affected in the United States in 2020 as elective surgeries were paused in response to the COVID-19 pandemic. This study sought to provide an updated estimate of inpatient total joint arthroplasty (TJA) case volumes in the United States in 2020. Methods: A retrospective cohort study was performed by identifying all adult patients who underwent primary, elective TJA from January 1st, 2017 to December 31st, 2020, using the National Inpatient Sample. Monthly and annual case volumes were reported with descriptive statistics. Baseline case volumes were established by taking the average number of monthly cases performed in 2017, 2018, and 2019. These monthly averages were compared to 2020 values. Results: From 2017 to 2019, the average case volume was 1,056,669 cases per year (41.0% THA, 59.0% TKA) and 88,055 cases per month. In 2020, 535,441 cases were identified (45.4% THA, 54.6% TKA), corresponding to a 49.3% reduction from the 2017-2019 annual average. Monthly cases decreased to 4515 in April during the "first wave" of COVID-19, corresponding to a 94.8% decrease from prior years. In June, cases rebounded to 55,520 before decreasing again in July to 50,100 during the "second wave" of COVID-19. During the "third wave," COVID-19 cases decreased month-over-month from October through December (56.5% decrease). Conclusions: This updated estimate identified a 49.3% decrease in inpatient TJA cases in 2020 compared to prior years. This is similar to the 46.5-47.7% decrease in case volume previously reported.
Language	English
Publishing date	2024-02-28
Publishing country	United States
Document type	Journal Article
ISSN	2352-3441
ISSN	2352-3441
DOI	10.1016/j.artd.2024.101336
Database	MEDical Literature Analysis and Retrieval System OnLINE

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