Safety of a Clinical Surveillance Protocol With 3- and 6-Week Warfarin Prophylaxis After Total Joint Arthroplasty
| Autor: | Matthew L. Jimenez, David S Bailie, Wayne M. Goldstein, Robin Wall, Jill Jasperson Branson |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.drug_class Arthroplasty Replacement Hip medicine.medical_treatment Scintigraphy Drug Administration Schedule Clinical Protocols Risk Factors Ventilation-Perfusion Ratio medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Early Ambulation Aged Retrospective Studies Postoperative Care Venous Thrombosis medicine.diagnostic_test business.industry Anticoagulant Warfarin Anticoagulants medicine.disease Bandages Combined Modality Therapy Arthroplasty Pulmonary embolism Surgery Venous thrombosis Treatment Outcome Female Drug Monitoring Safety Pulmonary Embolism Complication business Lower limbs venous ultrasonography medicine.drug |
| Zdroj: | Orthopedics. 24:651-654 |
| ISSN: | 1938-2367 0147-7447 |
| DOI: | 10.3928/0147-7447-20010701-13 |
| Popis: | The charts of 1869 patients were reviewed for the occurrence of deep venous thrombosis (DVT) and pulmonary embolism after total hip or knee arthroplasty. Prophylaxis consisted of 3 (group 1; n=1235) or 6 (group 2; n=634) weeks low-dose warfarin, pneumatic compression boots worn by patients in the hospital, mobilization on the first postoperative day, and a clinical surveillance protocol. Venous ultrasound or ventilation/perfusion lung scintigraphy (V/Q) was performed only if patients became symptomatic. In group 1 , duplex ultrasound was performed on 216 patients. Twenty-three (1.8%) patients were positive for DVT. Ventilation/perfusion lung scintigraphy was performed on 25 patients, and 5 (0.4%) patients were positive for pulmonary embolism. In group 2, 117 patients were evaluated for DvT, and 1 9 (3%) patients had positive results determined by ultrasound. Twentyfive patients were evaluated with V/Q, and only 1 (0.1 6%) patient was positive for pulmonary embolism. No patient developed a fatal pulmonary embolism or postphlebitic syndrome. This prophylaxis protocol is an efficient and cost-effective method for the prevention of significant events after surgery. |
| Databáze: | OpenAIRE |
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