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Venous thromboembolism rates after hip and knee arthroplasty and hip fractures

BACKGROUND: The ideal thromboprophylaxis regime following lower limb arthroplasty and proximal femur fractures remains controversial. Guidelines disagree on the type of chemical prophylaxis, its dose or duration. This article describes a method of monitoring venous thromboembolism (VTE) rates follow...

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Autores principales: Mula, Viswanath, Parikh, Sunny, Suresh, Sivakolundu, Bottle, Alex, Loeffler, Mark, Alam, Mahbub
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017506/
https://www.ncbi.nlm.nih.gov/pubmed/32050949
http://dx.doi.org/10.1186/s12891-020-3100-4
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author Mula, Viswanath
Parikh, Sunny
Suresh, Sivakolundu
Bottle, Alex
Loeffler, Mark
Alam, Mahbub
author_facet Mula, Viswanath
Parikh, Sunny
Suresh, Sivakolundu
Bottle, Alex
Loeffler, Mark
Alam, Mahbub
author_sort Mula, Viswanath
collection PubMed
description BACKGROUND: The ideal thromboprophylaxis regime following lower limb arthroplasty and proximal femur fractures remains controversial. Guidelines disagree on the type of chemical prophylaxis, its dose or duration. This article describes a method of monitoring venous thromboembolism (VTE) rates following Total Hip (THA), Total Knee Arthroplasty (TKA) and surgery for hip fractures (NOF#). METHODS: Over 3 years, all patients investigated for VTE were analysed using Picture Archiving Communications System (PACS). All positive scans were then cross-referenced using PACS and local registry data to see if they had undergone THA, TKA or NOF# in the preceding 90 days. Mortality data were obtained from the national administrative database, Hospital Episode Statistics. RESULTS: Five thousand seven hundred eighty-eight patients underwent investigation for VTE and there were 29 diagnoses of PE and 24 of DVT. There was a 0.77% rate of symptomatic DVT after THA, 0.05% after TKA and 0.55% after NOF #. The rate of confirmed symptomatic PE for THA was 0.46, 0.27% for TKA and 0.96% for NOF #. Mortality at one-year post-THA was 0.6, 0.6% for TKA and 25.9% after NOF#. All patients contacted either remained within the catchment area for the minimum 90 postoperative days or died within the catchment area. CONCLUSIONS: The 90 day post-operative prevalence of symptomatic VTE of 1.2, 0.3 and 1.5% in THA, TKA and NOF # respectively are similar to other studies using symptomatic and imaging positive VTE as their endpoint. The study uses a method of collecting data which can be utilised in centres where PACS is available.
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spelling pubmed-70175062020-02-20 Venous thromboembolism rates after hip and knee arthroplasty and hip fractures Mula, Viswanath Parikh, Sunny Suresh, Sivakolundu Bottle, Alex Loeffler, Mark Alam, Mahbub BMC Musculoskelet Disord Research Article BACKGROUND: The ideal thromboprophylaxis regime following lower limb arthroplasty and proximal femur fractures remains controversial. Guidelines disagree on the type of chemical prophylaxis, its dose or duration. This article describes a method of monitoring venous thromboembolism (VTE) rates following Total Hip (THA), Total Knee Arthroplasty (TKA) and surgery for hip fractures (NOF#). METHODS: Over 3 years, all patients investigated for VTE were analysed using Picture Archiving Communications System (PACS). All positive scans were then cross-referenced using PACS and local registry data to see if they had undergone THA, TKA or NOF# in the preceding 90 days. Mortality data were obtained from the national administrative database, Hospital Episode Statistics. RESULTS: Five thousand seven hundred eighty-eight patients underwent investigation for VTE and there were 29 diagnoses of PE and 24 of DVT. There was a 0.77% rate of symptomatic DVT after THA, 0.05% after TKA and 0.55% after NOF #. The rate of confirmed symptomatic PE for THA was 0.46, 0.27% for TKA and 0.96% for NOF #. Mortality at one-year post-THA was 0.6, 0.6% for TKA and 25.9% after NOF#. All patients contacted either remained within the catchment area for the minimum 90 postoperative days or died within the catchment area. CONCLUSIONS: The 90 day post-operative prevalence of symptomatic VTE of 1.2, 0.3 and 1.5% in THA, TKA and NOF # respectively are similar to other studies using symptomatic and imaging positive VTE as their endpoint. The study uses a method of collecting data which can be utilised in centres where PACS is available. BioMed Central 2020-02-12 /pmc/articles/PMC7017506/ /pubmed/32050949 http://dx.doi.org/10.1186/s12891-020-3100-4 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mula, Viswanath
Parikh, Sunny
Suresh, Sivakolundu
Bottle, Alex
Loeffler, Mark
Alam, Mahbub
Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
title Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
title_full Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
title_fullStr Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
title_full_unstemmed Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
title_short Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
title_sort venous thromboembolism rates after hip and knee arthroplasty and hip fractures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017506/
https://www.ncbi.nlm.nih.gov/pubmed/32050949
http://dx.doi.org/10.1186/s12891-020-3100-4
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