Incidence of venous thromboembolism and thromboprophylaxis after total hip or knee arthroplasty

Buchan, DS; Bajorek, B

Incidence of venous thromboembolism and thromboprophylaxis after total hip or knee arthroplasty

Buchan, DS Bajorek, B

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Publication Type:: Journal Article
Citation:: Journal of Pharmacy Practice and Research, 2008, 38 (3), pp. 200 - 204
Issue Date:: 2008-01-01

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Field	Value	Language
dc.contributor.author	Buchan, DS	en_US
dc.contributor.author	Bajorek, B https://orcid.org/0000-0002-2532-7187	en_US
dc.date.issued	2008-01-01	en_US
dc.identifier.citation	Journal of Pharmacy Practice and Research, 2008, 38 (3), pp. 200 - 204	en_US
dc.identifier.issn	1445-937X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/16990
dc.description.abstract	Background: Despite numerous guidelines and consensus statements on venous thromboembolism (VTE) prophylaxis, there appears to be a large gap between evidence and practice. Aim: To identify the incidence of VTE, thromboprophylaxis practice, VTE risk factors, and bleeding complications in patients undergoing elective total hip or knee arthroplasty. Method: Patients who underwent elective total hip or knee arthroplasty from 1 January 2004 to 31 December 2005 were identified retrospectively from medical records at two hospitals. A clinical case audit was performed and data collected on the 3-month incidence of VTE, thromboprophylaxis practice, VTE risk factors and bleeding episodes. Results: VTE incidence was 13% (in-hospital incidence 9.3% and 3-month readmission incidence 3.3%) and was significantly higher at Hospital 1 for unilateral total knee arthroplasty (p= 0.02) and unilateral total hip arthroplasty (p = 0.02). At both hospitals the 3-month incidence of VTE was 16% post unilateral total knee arthroplasty compared to 7.7% post unilateral total hip arthroplasty (p = 0.06). 99% of patients received appropriate pharmacological prophylaxis and of these 87% received an appropriate dose. 17 patients (55%) that developed VTE had one or more risk factors. There were 23 cases (9.30%) of minor bleeding and 4 cases (1.6%) of major bleeding. Conclusion: VTE incidence was higher than that quoted in the literature, which may reflect high usage of pre-discharge deep vein thrombosis screening in the study population. There is a need to develop and disseminate management algorithms for elective total hip or knee arthroplasty in the local setting.	en_US
dc.relation.ispartof	Journal of Pharmacy Practice and Research	en_US
dc.relation.isbasedon	10.1002/j.2055-2335.2008.tb00838.x	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.title	Incidence of venous thromboembolism and thromboprophylaxis after total hip or knee arthroplasty	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	38	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	38	en_US

Abstract:

Background: Despite numerous guidelines and consensus statements on venous thromboembolism (VTE) prophylaxis, there appears to be a large gap between evidence and practice. Aim: To identify the incidence of VTE, thromboprophylaxis practice, VTE risk factors, and bleeding complications in patients undergoing elective total hip or knee arthroplasty. Method: Patients who underwent elective total hip or knee arthroplasty from 1 January 2004 to 31 December 2005 were identified retrospectively from medical records at two hospitals. A clinical case audit was performed and data collected on the 3-month incidence of VTE, thromboprophylaxis practice, VTE risk factors and bleeding episodes. Results: VTE incidence was 13% (in-hospital incidence 9.3% and 3-month readmission incidence 3.3%) and was significantly higher at Hospital 1 for unilateral total knee arthroplasty (p= 0.02) and unilateral total hip arthroplasty (p = 0.02). At both hospitals the 3-month incidence of VTE was 16% post unilateral total knee arthroplasty compared to 7.7% post unilateral total hip arthroplasty (p = 0.06). 99% of patients received appropriate pharmacological prophylaxis and of these 87% received an appropriate dose. 17 patients (55%) that developed VTE had one or more risk factors. There were 23 cases (9.30%) of minor bleeding and 4 cases (1.6%) of major bleeding. Conclusion: VTE incidence was higher than that quoted in the literature, which may reflect high usage of pre-discharge deep vein thrombosis screening in the study population. There is a need to develop and disseminate management algorithms for elective total hip or knee arthroplasty in the local setting.

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http://hdl.handle.net/10453/16990