VTE after major orthopaedic surgery: a serious problem requiring adequate thromboprophylaxis
Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major contributor to morbidity and mortality worldwide.
- VTE is the immediate cause of death in approximately 10% of acute-care patients who die in hospital5
- Major orthopaedic surgery, such as elective total hip replacement (THR) and total knee replacement (TKR), is associated with a high incidence of postoperative VTE6
- Approximately half of patients undergoing major orthopaedic surgery will develop venous blood clots if they do not receive preventive care6
- Approximately half of patients undergoing major orthopaedic surgery will develop venous blood clots if they do not receive preventive care6
- Current guidelines recommend pharmacological VTE prevention in patients undergoing major orthopaedic surgery6
- Prophylaxis with a low molecular weight heparin (such as enoxaparin), fondaparinux or a vitamin K antagonist is recommended6
- Despite the existence of such guidelines and clinical evidence for the effectiveness of thromboprophylaxis, a significant proportion of patients do not receive adequate thromboprophylaxis7
- A multinational survey revealed that 64% of surgical patients were at risk of VTE; of these at risk, less than 60% received the recommended thromboprophylaxis7
- 5 - Anderson FA Jr, Zayaruzny M, Heit JA, Fidan D, Cohen AT. Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism. Am J Hematol. 2007;82(9):777-782.
- 6 - Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):381S-453S.
- 7 - Cohen AT, Tapson VF, Bergmann JF, et al; ENDORSE Investigators. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet. 2008;371(9610):387-394.
- Thrombosis
- Formation of a clot inside a blood vessel.
- Venous thromboembolism
- A disease process beginning with a blood clot occurring within the venous system, including deep vein thrombosis and pulmonary embolism.
- Low molecular weight heparin
- An anticoagulant used to prevent new clots forming and existing clots from getting larger. It is injected subcutaneously (under the skin).
- Major orthopaedic surgery
- Major operations on the bones or joints including total hip or knee replacement surgery.
- Thromboprophylaxis
- Preventative treatment for blood clotting.
