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    Physician compliance with guidelines for deep-vein thrombosis prevention in total hip and knee arthroplasty

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    Authors
    Friedman, Richard J.
    Gallus, Alexander S.
    Cushner, Fred D.
    Fitzgerald, Gordon
    Anderson, Frederick A. Jr.
    Global Orthopaedic Registry Investigators
    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2008-01-22
    Keywords
    Aged
    Arthroplasty, Replacement, Hip
    Arthroplasty, Replacement, Knee
    Female
    Follow-Up Studies
    *Guideline Adherence
    Health Planning Guidelines
    Humans
    Male
    Middle Aged
    *Physicians
    Societies, Medical
    Venous Thromboembolism
    Venous Thrombosis
    Cardiovascular Diseases
    Health Information Technology
    Health Services Administration
    Health Services Research
    Orthopedics
    Preventive Medicine
    Surgical Procedures, Operative
    Therapeutics
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    Link to Full Text
    https://www.tandfonline.com/doi/abs/10.1185/030079908X242746
    Abstract
    OBJECTIVE: Despite evidence-based guidelines for venous thromboembolism (VTE) prevention after total hip or knee arthroplasty (THA/TKA), many patients may not receive effective prophylaxis. Our objective was to analyze data from the multinational Global Orthopaedic Registry (GLORY) to evaluate the compliance of surgeons with the American College of Chest Physicians (ACCP) guidelines for VTE prevention. RESEARCH DESIGN AND METHODS: Data from 8160 patients who had undergone a primary, unilateral, elective THA (n = 3950) or TKA (n = 4210), and had at least 3 months of follow-up were analyzed. RESULTS: Almost all patients received a form of recommended prophylaxis. Compliance with guidelines in terms of type, duration, start time, and dose was achieved for 47% of THA and 61% of TKA patients in the USA, and 62% of THA and 69% of TKA patients outside the USA. Warfarin use, mostly in the USA, was fully compliant in 33% of THA and 48% of TKA patients. Low-molecular-weight heparin use was fully compliant in 63% of THA and 72% of TKA patients in the USA, and 67% of THA and 73% of TKA patients outside the USA. CONCLUSION: Although almost all THA and TKA patients both inside and outside the USA received prophylaxis, a large proportion did not receive treatment in accordance with the ACCP guidelines. Our study may have overestimated the use of recommended prophylaxis as some participating investigators may have had a specific interest in VTE prophylaxis. Furthermore, although analyses were restricted to approximately three-quarters of patients who had outpatient follow-up data, their characteristics were similar to those in the entire population.
    Source

    Curr Med Res Opin. 2008 Jan;24(1):87-97. Link to article on publisher's site

    DOI
    10.1185/030079908X242746
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27140
    PubMed ID
    18028586
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1185/030079908X242746
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