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dc.contributor.authorFriedman, Richard J.
dc.contributor.authorGallus, Alexander S.
dc.contributor.authorCushner, Fred D.
dc.contributor.authorFitzgerald, Gordon
dc.contributor.authorAnderson, Frederick A. Jr.
dc.contributor.authorGlobal Orthopaedic Registry Investigators
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:38Z
dc.date.available2022-08-23T15:43:38Z
dc.date.issued2008-01-22
dc.date.submitted2011-09-21
dc.identifier.citation<p>Curr Med Res Opin. 2008 Jan;24(1):87-97. <a href="http://dx.doi.org/10.1185/030079908X242746 ">Link to article on publisher's site</a></p>
dc.identifier.issn0300-7995 (Linking)
dc.identifier.doi10.1185/030079908X242746
dc.identifier.pmid18028586
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27140
dc.description.abstractOBJECTIVE: 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.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=18028586&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.tandfonline.com/doi/abs/10.1185/030079908X242746
dc.subjectAged
dc.subjectArthroplasty, Replacement, Hip
dc.subjectArthroplasty, Replacement, Knee
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subject*Guideline Adherence
dc.subjectHealth Planning Guidelines
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subject*Physicians
dc.subjectSocieties, Medical
dc.subjectVenous Thromboembolism
dc.subjectVenous Thrombosis
dc.subjectCardiovascular Diseases
dc.subjectHealth Information Technology
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectOrthopedics
dc.subjectPreventive Medicine
dc.subjectSurgical Procedures, Operative
dc.subjectTherapeutics
dc.titlePhysician compliance with guidelines for deep-vein thrombosis prevention in total hip and knee arthroplasty
dc.typeJournal Article
dc.source.journaltitleCurrent medical research and opinion
dc.source.volume24
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_glory/6
dc.identifier.contextkey2249948
html.description.abstract<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathcor_glory/6
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages87-97


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