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    Insufficient duration of venous thromboembolism prophylaxis after total hip or knee replacement when compared with the time course of thromboembolic events: findings from the Global Orthopaedic Registry

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    Authors
    Warwick, David
    Friedman, Richard J.
    Agnelli, Giancarlo
    Gil-Garay, Enrique
    Johnson, Kirk
    Fitzgerald, Gordon
    Turibio, Flavio
    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2007-06-07
    Keywords
    Aged
    Anticoagulants
    Arthroplasty, Replacement, Hip
    Arthroplasty, Replacement, Knee
    Drug Administration Schedule
    Female
    Humans
    Male
    Middle Aged
    *Registries
    Thromboembolism
    Time Factors
    Venous Thrombosis
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1302/0301-620X.89B6.18844
    Abstract
    Patients who have undergone total hip or knee replacement (THR and TKR, respectively) are at high risk of venous thromboembolism. We aimed to determine the time courses of both the incidence of venous thromboembolism and effective prophylaxis. Patients with elective primary THR and TKR were enrolled in the multi-national Global Orthopaedic Registry. Data on the incidence of venous thromboembolism and prophylaxis were collected from 6639 THR and 8326 TKR patients. The cumulative incidence of venous thromboembolism within three months of surgery was 1.7% in the THR and 2.3% in the TKR patients. The mean times to venous thromboembolism were 21.5 days (sd 22.5) for THR, and 9.7 days (sd 14.1) for TKR. It occurred after the median time to discharge in 75% of the THR and 57% of the TKA patients who developed venous thromboembolism. Of those who received recommended forms of prophylaxis, approximately one-quarter (26% of THR and 27% of TKR patients) were not receiving it seven days after surgery, the minimum duration recommended at the time of the study. The risk of venous thromboembolism extends beyond the usual period of hospitalisation, while the duration of prophylaxis is often shorter than this. Practices should be re-assessed to ensure that patients receive appropriate durations of prophylaxis.
    Source
    J Bone Joint Surg Br. 2007 Jun;89(6):799-807. Link to article on publisher's site
    DOI
    10.1302/0301-620X.89B6.18844
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27141
    PubMed ID
    17613508
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1302/0301-620X.89B6.18844
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    GLORY Publications

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