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Journals / Acta Orthopaedica et Traumatologica Turcica / 2008 / Cilt: 42 - Sayı: 5

Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study

Majör ortopedik cerrahilerde venöz tromboemboli profilaksisi: Çokmerkezli, prospektif, gözlem çalışması

FAİK ALTINTAŞ
Hakan GÜRBÜZ
Bülent ERDEMLİ
BÜLENT ATİLLA
Recep Gür USTAOĞLU
Uğur ÖZİÇ
Öner ŞAVK
Hüseyin BAYRAM
Recep MEMİK
Işık AKGÜN
Abdullah GÖĞÜŞ
Fatih PESTİLCİ
Adnan KONAL
Mahmut ARGÜN
İRFAN ÖZTÜRK
Nevzat DABAK
Ömer Faruk BİLGEN
Erhan SERİN
Çetin ÖNDER
Aykın ŞİMŞEK
Remzi TÖZÜN
Hakan KINIK
Pages
322–327
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.

📌 3 Key Takeaways

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Objective & Hypothesis:Objectives: We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS).
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Key Findings & Data:Methods: An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients.
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Conclusion & Impact:Conclusion: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Artroplasti · replasman · kalça

Abstract

Objectives: We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS). Methods: An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients. Results: Risk factors for VTE were seen in 73.2% of the patents, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively. Conclusion: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.

Özet

Amaç: Ülkemizde majör ortopedik cerrahi (MOC) için farmakolojik profilaksi uygulanan hastalarda venöz tromboembolizm (VTE) risk faktörleri, kullanılan profilaksi yöntemleri ve klinik bulgu veren derin ven trombozu (DVT) ve pulmoner emboli (PE) sıklığı araştırıldı. Çalışma planı: Prospektif, çokmerkezli, açık, müdahalesiz bir gözlem çalışması planlanarak, 21 merkezden 899 hasta çalışmaya alındı. Olguların 316’sında (%35.2) total kalça protezi (TKP), 328’inde (%36.5) total diz protezi (TDP), 255’inde (%28.4) kalça kırığı (KK) cerrahisi uygulandı. Tüm hastalarda farmakolojik DVT profilaksisine başvuruldu. Sonuçlar: Olguların %73.2’sinde VTE risk faktörleri vardı. En sık görülen risk faktörleri obezite (%72) ve uzamış immobilizasyon (%36.3) idi. Profilaksi için olguların %91.1’inde düşük molekül ağırlıklı heparin, %8.9’unda fondaparinuks kullanıldı. Olguların 273’üne (%30.4) kısa dönem, 626’sına (%69.6) uzun dönem profilaksi uygulandı. Mekanik profilaksi 610 olguda (%67.9) elastik çorap ile, 67 olguda (%7.5) aralıklı hava basınç cihazı ile uygulandı. Üç aylık takip sonucunda sekiz olguda (%0.9) klinik bulgu veren DVT, dört olguda (%0.4) PE gelişti. Mortalite 10 olguda (%1.1) görüldü. Kanama komplikasyonu sekiz olguda (%0.9) majör, 40 olguda (%4.5) minör idi. Çıkarımlar: Etkin VTE profilaksi yapıldığında MOC’de klinik bulgu veren DVT ve PE oranları düşük olmaktadır.

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Cite This Article

ALTINTAŞ, F., GÜRBÜZ, H., ERDEMLİ, B., ATİLLA, B., USTAOĞLU, R. G., ÖZİÇ, U., ŞAVK, Ö., BAYRAM, H., MEMİK, R., AKGÜN, I., GÖĞÜŞ, A., PESTİLCİ, F., KONAL, A., ARGÜN, M., ÖZTÜRK, İ., DABAK, N., BİLGEN, Ö. F., SERİN, E., ÖNDER, Ç., ŞİMŞEK, A., TÖZÜN, R., KINIK, H. (2008). Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study. Acta Orthopaedica et Traumatologica Turcica, Cilt: 42 - Sayı: 5, 322–327. https://ajindex.com/articles/354471

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