Thromboprophylaxis for Orthopedic patients in Turkey

Fracture neck of femur surgery, total hip replacement, total knee replacement patients are at high risk of developing VTE as seen in western population. In India, there are still mixed opinions among the orthopedic surgeons about the increased risk of VTE in Indian population going for orthopedic surgeries.

It is interesting to note the results of the study from Turkey given below. this is a large study and worth to note their findings.

J Bras Pneumol. 2013 Jun;39(3). 

Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?Akpinar EE, Hosgün D, Akan B, Ates C, Gülhan M. Source  Ufuk University, Department of Chest Diseases, Ankara, Turkey.Abstract

OBJECTIVE:

Pulmonary embolism (PE) is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital.

METHODS:

Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair) between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT) were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities.

RESULTS:

We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively) within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE.

CONCLUSIONS:

Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age).