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Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China

BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication after arthroplasty. Numerous prophylactic strategies and studies to reduce VTEs have focused on the duration of the hospital stay and on few extramural hospitals. This study aimed to investigate extramural hospital manageme...

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Autores principales: Tong, Kai, Liu, Hankun, Qin, Jun, Pan, Zhengqi, Shangguan, Yangfan, Xiao, Hao, Wang, Hua, Chen, Liaobin, Tan, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438984/
https://www.ncbi.nlm.nih.gov/pubmed/34517870
http://dx.doi.org/10.1186/s12891-021-04663-1
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author Tong, Kai
Liu, Hankun
Qin, Jun
Pan, Zhengqi
Shangguan, Yangfan
Xiao, Hao
Wang, Hua
Chen, Liaobin
Tan, Yang
author_facet Tong, Kai
Liu, Hankun
Qin, Jun
Pan, Zhengqi
Shangguan, Yangfan
Xiao, Hao
Wang, Hua
Chen, Liaobin
Tan, Yang
author_sort Tong, Kai
collection PubMed
description BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication after arthroplasty. Numerous prophylactic strategies and studies to reduce VTEs have focused on the duration of the hospital stay and on few extramural hospitals. This study aimed to investigate extramural hospital management of VTE after total hip/knee arthroplasty (THA/TKA) in China with a novel survey tool. METHODS: A total of 180 patients undergoing arthroplasty, including 68 THA patients and 112 TKA patients, were enrolled in this study. All patients received anticoagulant treatment management. A survey querying VTE management and adherence, such as therapy information, understanding of anticoagulation, satisfaction with the ability of medical staff, and satisfaction with health care costs, was administered by a questionnaire (TKA/THA Patients’ Experience with Anticoagulation in the Post-discharge Period) for quality improvement. RESULTS: The average age of the patients was 65.27 ± 13.62 years. All patients knew their follow-up times. 85 % of them were suggested that re-examine at the next 14 days, and the others at the next 28 days. All patients continued to visit the orthopaedic clinic after discharge without choosing other types of outpatient services, such as an anticoagulant clinic or home visit with a nurse/pharmacist or remote evaluation by telephone. A total of 96.6 % of all patients used new oral anticoagulants, and the most common treatment duration was 2–4 weeks (93.3 %). 48 % informed their physicians that they were taking anticoagulation medications when they visited ophthalmology, dentistry, dermatology, and other departments. The overall rate of satisfaction with anticoagulation management was 81.67 %, and 6.67 % of patients were not unsatisfied with their medical expenses. Patient compliance decreased with increasing follow-up time. Continuous follow-ups after discharge significantly improved patient compliance. CONCLUSIONS: These results elucidate how we can improve the quality of anticoagulation. Continuous follow-up appointments for 30 days after discharge, especially for individuals over 65 years old, significantly improved patient satisfaction and reduced the incidence of VTE and medical costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04663-1.
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spelling pubmed-84389842021-09-14 Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China Tong, Kai Liu, Hankun Qin, Jun Pan, Zhengqi Shangguan, Yangfan Xiao, Hao Wang, Hua Chen, Liaobin Tan, Yang BMC Musculoskelet Disord Research BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication after arthroplasty. Numerous prophylactic strategies and studies to reduce VTEs have focused on the duration of the hospital stay and on few extramural hospitals. This study aimed to investigate extramural hospital management of VTE after total hip/knee arthroplasty (THA/TKA) in China with a novel survey tool. METHODS: A total of 180 patients undergoing arthroplasty, including 68 THA patients and 112 TKA patients, were enrolled in this study. All patients received anticoagulant treatment management. A survey querying VTE management and adherence, such as therapy information, understanding of anticoagulation, satisfaction with the ability of medical staff, and satisfaction with health care costs, was administered by a questionnaire (TKA/THA Patients’ Experience with Anticoagulation in the Post-discharge Period) for quality improvement. RESULTS: The average age of the patients was 65.27 ± 13.62 years. All patients knew their follow-up times. 85 % of them were suggested that re-examine at the next 14 days, and the others at the next 28 days. All patients continued to visit the orthopaedic clinic after discharge without choosing other types of outpatient services, such as an anticoagulant clinic or home visit with a nurse/pharmacist or remote evaluation by telephone. A total of 96.6 % of all patients used new oral anticoagulants, and the most common treatment duration was 2–4 weeks (93.3 %). 48 % informed their physicians that they were taking anticoagulation medications when they visited ophthalmology, dentistry, dermatology, and other departments. The overall rate of satisfaction with anticoagulation management was 81.67 %, and 6.67 % of patients were not unsatisfied with their medical expenses. Patient compliance decreased with increasing follow-up time. Continuous follow-ups after discharge significantly improved patient compliance. CONCLUSIONS: These results elucidate how we can improve the quality of anticoagulation. Continuous follow-up appointments for 30 days after discharge, especially for individuals over 65 years old, significantly improved patient satisfaction and reduced the incidence of VTE and medical costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04663-1. BioMed Central 2021-09-13 /pmc/articles/PMC8438984/ /pubmed/34517870 http://dx.doi.org/10.1186/s12891-021-04663-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Tong, Kai
Liu, Hankun
Qin, Jun
Pan, Zhengqi
Shangguan, Yangfan
Xiao, Hao
Wang, Hua
Chen, Liaobin
Tan, Yang
Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China
title Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China
title_full Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China
title_fullStr Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China
title_full_unstemmed Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China
title_short Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China
title_sort current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in china
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438984/
https://www.ncbi.nlm.nih.gov/pubmed/34517870
http://dx.doi.org/10.1186/s12891-021-04663-1
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