Prognosis of venous thromboembolism in orthopaedic surgery or trauma patients and use of thromboprophylaxis
| Autor: | J.A. Nieto, Javier Trujillo-Santos, R. Valle, A. Erice Calvo-Sotelo, Carmen Fernández-Capitán, M. Monreal, J.A. Hernandez-Hermoso, Juan I. Arcelus, J. Gutiérrez Guisado, L. Bertoletti |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Deep-vein thrombosis
medicine.medical_specialty medicine.medical_treatment Non-major orthopaedic surgery 030204 cardiovascular system & hematology Major bleeding Lower risk 03 medical and health sciences 0302 clinical medicine Recurrent thromboembolism Medicine 030212 general & internal medicine Trauma not requiring surgery Hip fracture business.industry Pulmonary embolism General Medicine medicine.disease Arthroplasty Surgery Orthopedic surgery business Venous thromboembolism |
| Zdroj: | Revista Clinica Espanola r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname |
| ISSN: | 0014-2565 |
| Popis: | Background: There is scarce evidence about the prognosis of venous thromboembolism in patients undergoing orthopedic surgery and in patients suffering non-surgical trauma. Methods: We used the RIETE database (Registro Informatizado de pacientes con Enfermedad Trombo Embolica) to compare the prognosis of venous thromboembolism and the use of thromboprophylaxis in patients undergoing different orthopedic procedures and in trauma patients not requiring surgery. Results: From March 2001 to March 2015, a total of 61,789 patients were enrolled in RIETE database. Of these, 943 (1.52%) developed venous thromboembolism after elective arthroplasty, 445 (0.72%) after hip fracture, 1,045 (1.69%) after non-major orthopedic surgery and 2,136 (3.46%) after non-surgical trauma. Overall, 2,283 patients (50%) initially presented with pulmonary embolism. Within the first 90 days of therapy, 30 patients (0.66%; 95% CI 0.45-0.93) died from pulmonary embolism. The rate of fatal pulmonary embolism was significantly higher after hip fracture surgery (n = 9 [2.02%]) than after elective arthroplasty (n = 5 [0.53%]), non-major orthopedic surgery (n = 5 [0.48%]) or non surgical trauma (n = 11 [0.48%]). Thromboprophylaxis was more commonly used for hip fracture (93%) or elective arthroplasty (94%) than for non-major orthopedic surgery (71%) or non-surgical trauma (32%). Major bleeding was significantly higher after hip fracture surgery (4%) than that observed after elective arthroplasty (1.6%), non-major orthopedic surgery (1.5%) or non-surgical trauma (1.4%). Conclusions: Thromboprophylaxis was less frequently used in lower risk procedures despite the absolute number of fatal pulmonary embolism after non-major orthopedic surgery or nonsurgical trauma, exceeded that observed after high risk procedures. (C) 2018 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved. |
| Databáze: | OpenAIRE |
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