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
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
复制标题
DOI：
10.1302/0301-620x.89b6.18844
复制
发表时间：
2007-06-01
影响因子：
--
通讯作者：
Turibio, F. M.
中科院分区：
文献类型：
--
作者：
Warwick, D.;Friedman, R. J.;Turibio, F. M.
接受全髋关节或全膝关节置换术（分别为THR和TKR）的患者发生静脉血栓栓塞的风险较高。我们的目的是确定静脉血栓栓塞发生率和有效预防的时间进程。选择性初次THR和TKR的患者入组多国全球骨科登记研究。收集了6639例THR和8326例TKR患者的静脉血栓栓塞发生率和预防数据，THR和TKR患者术后3个月内静脉血栓栓塞的累积发生率分别为1.7%和2.3%。THR组至静脉血栓栓塞的平均时间为21.5天（SD 22.5），TKR组为9.7天（SD 14.1）。75%的THR患者和57%的TKA患者在中位出院时间后发生静脉血栓栓塞。在接受推荐的预防措施的患者中，大约四分之一（26%的THR患者和27%的TKR患者）在手术后7天没有接受预防措施，这是研究时推荐的最短持续时间。静脉血栓栓塞的风险超出了通常的住院时间，而预防措施的持续时间通常短于此。应重新评估实践，以确保患者接受适当的预防持续时间。
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.