Evaluation of Appropriate Venous Thromboembolism Prophylaxis in Patients With Orthopaedic Trauma With Symptom-Driven Vascular and Radiographic Studies
| Autor: | Christopher M. Domes, Daphne M. Beingessner, Anneliese M. Schleyer, James McQueen, Ronald Pergamit |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent MEDLINE 03 medical and health sciences Young Adult 0302 clinical medicine Injury Severity Score Postoperative Complications Trauma Centers Internal medicine medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures cardiovascular diseases Young adult Aged Retrospective Studies Aged 80 and over business.industry Medical record Trauma center 030208 emergency & critical care medicine Retrospective cohort study Ultrasonography Doppler General Medicine Evidence-based medicine Venous Thromboembolism Middle Aged Population study Blood Vessels Wounds and Injuries Surgery Female Guideline Adherence business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | Journal of orthopaedic trauma. 31(12) |
| ISSN: | 1531-2291 |
| Popis: | Objective To evaluate venous thromboembolism (VTE) prophylaxis adherence and effectiveness in orthopaedic trauma patients who had vascular or radiographic studies showing deep vein thromboses or pulmonary emboli. Design Retrospective review. Setting A level I trauma center that independently services a 5-state region. Patients Four hundred seventy-six patients with orthopaedic trauma who underwent operative treatments for orthopaedic injuries and had symptom-driven diagnostic VTE studies. Intervention The medical records of patients treated surgically between July 2010 and March 2013 were interrogated using a technical tool that electronically captures thrombotic event data from vascular and radiologic imaging studies by natural language processing. Main outcome measurements Patients were evaluated for hospital guideline-directed VTE prophylaxis adherence with mechanical or chemical prophylaxis. Patient demographics, associated injuries, mechanism of injury, and symptoms that led to imaging for a VTE were also assessed. Results Of the 476 orthopaedic patients who met inclusion criteria, 100 (mean age 52.3 median 52, SD 18.3, 70% men) had positive VTE studies. Three hundred seventy-six (age 47.3, SD 17.3, 69% men) had negative VTE studies. Of the 100 patients with VTE, 63 deep vein thromboses, and 49 pulmonary emboli were found. Eight-five percent of all patients met hospital guideline-VTE prophylaxis standards. Conclusion The study population had better than previously reported VTE prophylaxis adherence, however, patients still developed VTEs. Level of evidence Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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