Tonghua Chen,1,* Xiaojun Lei,1,* Jingwei Tian,1,* Haochen Mai,1 Yuanfang Yu,1 Wenxia Wu,1 Liqiang Wen,1 Phei Er Saw,1 Meng Zhang1,2 

1Department of General Practice, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China; 2Department of General Practice, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Shanwei, Guangdong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Phei Er Saw; Meng Zhang, Email caipeie@mail.sysu.edu.cn; zhangm7@mail.sysu.edu.cn

Purpose: To minimize the occurrence of acute thromboembolic events in elderly patients during the perioperative period and prevent adverse clinical outcomes, this study explores an efficient, and precise approach to the formulation of antithrombotic regimens under a multidisciplinary team (MDT) consultation model.
Patients and Methods: This single-center retrospective study included elderly patients on long-term antithrombotic therapy who underwent orthopedic surgery in our hospital between January 2019 and May 2023. Patients were divided into two groups: the MDT group and the non-MDT group. The incidence of thrombotic and bleeding-related adverse events during the perioperative period was observed and compared between the two groups.
Results: A total of 436 patients were enrolled, among whom 32 (7.3%) experienced thromboembolic adverse events. The incidence was significantly lower in the MDT group compared to the non-MDT group (3.3% vs 8.9%, P = 0.043). Logistic regression analysis identified several significant factors associated with thromboembolic adverse events, including: type of antithrombotic medication (OR=1.508, P=0.009) and postoperative ICU transfer (OR=6.390, P=0.029) were positively associated with thrombotic events; multidisciplinary team (OR=0.215, P=0.011) demonstrated a protective effect (negative association).
Conclusion: The multidisciplinary consultation model improves perioperative antithrombotic management strategies for elderly patients, contributing to a reduced incidence of thrombotic events in orthopedic surgeries for this population.

Keywords: elderly, antithrombotic therapy, perioperative period, multidisciplinary team, thrombotic adverse events