Clinical characteristics and influencing factors of liver injury induced by enoxaparin sodium in elderly patients undergoing knee arthroplasty

Chen Nana; Ge Suqin

doi:10.3969/j.issn.1672-8157.2025.04.036

Abstract：Objective To investigate the current risks and influencing factors of liver injury induced by enoxaparin sodium in elderly patients undergoing knee arthroplasty.Methods Medical records of 194 patients who underwent knee arthroplasty for the first time and received enoxaparin sodium postoperatively in the 904th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from March 2022 to December 2024 were collected.By using the Roussel Uclaf Causality Assessment Method(RUCAM),the patients were screened out who were highly likely,more likely,or likely to suffer liver injury after the use of enoxaparin sodium.Logistic regression analysis was then conducted to identify the influencing factors associated with enoxaparin sodium-induced liver injury.Results Among the 194 elderly patients who received enoxaparin sodium after total knee arthroplasty,21 cases(10.82%,21/194)experienced liver injury.The average Roussel Uclaf Causality Assessment score was(6.09±1.42)points,and the average onset time of liver injury was(6.34±1.93)days.According to the Council for International Organizations of Medi-cal Sciences(CIOMS)classification of liver injury,hepatocellular injury was observed in 5 cases(23.81%,5/21),and biochemical liver test abnormalities were observed in 16 cases(76.19%,16/21).Significant differences were found between the abnormal liver function group and the normal liver function group in terms of gender,presence of diabetes,drug dosage,and alcohol consumption(χ2=4.785,8.747,4.654,8.157,all P<0.05).The results of multivariate logistic regression analysis showed that gender,diabetes,drug dosage,and alcohol consumption all had significant impacts on the occurrence of liver injury induced by enoxaparin sodium(P<0.05).Conclusion In elderly patients undergoing total knee arthroplasty,the incidence of liver injury caused by the use of enoxaparin sodium for postoperative anticoagulation is slightly higher.Male gender,diabetes,high drug dosage,and alcohol consumption are all independent influencing factors for enoxaparin sodium-induced liver injury.