Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study

Faik Altintas; Hakan Gurbuz; Bulent Erdemli; Bulent Atilla; Recep Ustaoglu; Ugur Ozic; Oner Savk; Huseyin Bayram; Recep Memik; Isık Akgun; Abdullah Gogus; Fatih Pestilci; Adnan Konal; Mahmut Argun; Irfan Ozturk; Nevzat Dabak; Omer Bilgen; Erhan Serin; Cetin Onder; Aykın Simsek; Remzi Tozun; Hakan Kinik

Research Article

Majör ortopedik cerrahilerde venöz tromboemboli profilaksisi: Çokmerkezli, prospektif, gözlem çalışması

Year 2008, Volume: 42 Issue: 5, 322 - 327, 19.01.2009

Faik Altintas Hakan Gurbuz Bulent Erdemli Bulent Atilla Recep Ustaoglu Ugur Ozic Oner Savk Huseyin Bayram Recep Memik Isık Akgun Abdullah Gogus Fatih Pestilci Adnan Konal Mahmut Argun Irfan Ozturk Nevzat Dabak Omer Bilgen Erhan Serin Cetin Onder Aykın Simsek Remzi Tozun Hakan Kinik

Abstract

Amaç: Ülkemizde majör ortopedik cerrahi (MOC) için farmakolojik profilaksi uygulanan hastalarda venöz tromboembolizm (VTE) risk faktörleri, kullanılan profilaksi yöntemleri ve klinik bulgu veren derin ven trombozu (DVT) ve pulmoner emboli (PE) sıklığı araştırıldı.
Çalışma planı: Prospektif, çokmerkezli, açık, müdahalesiz bir gözlem çalışması planlanarak, 21 merkezden 899 hasta çalışmaya alındı. Olguların 316’sında (%35.2) total kalça protezi (TKP), 328’inde (%36.5) total diz protezi (TDP), 255’inde (%28.4) kalça kırığı (KK) cerrahisi uygulandı. Tüm hastalarda farmakolojik DVT profilaksisine başvuruldu.
Sonuçlar: Olguların %73.2’sinde VTE risk faktörleri vardı. En sık görülen risk faktörleri obezite (%72) ve uzamış immobilizasyon (%36.3) idi. Profilaksi için olguların %91.1’inde düşük molekül ağırlıklı heparin, %8.9’unda fondaparinuks kullanıldı. Olguların 273’üne (%30.4) kısa dönem, 626’sına (%69.6) uzun dönem profilaksi uygulandı. Mekanik profilaksi 610 olguda (%67.9) elastik çorap ile, 67 olguda (%7.5) aralıklı hava basınç cihazı ile uygulandı. Üç aylık takip sonucunda sekiz olguda (%0.9) klinik bulgu veren DVT, dört olguda (%0.4) PE gelişti. Mortalite 10 olguda (%1.1) görüldü. Kanama komplikasyonu sekiz olguda (%0.9) majör, 40 olguda (%4.5) minör idi.
Çıkarımlar: Etkin VTE profilaksi yapıldığında MOC’de klinik bulgu veren DVT ve PE oranları düşük olmaktadır.

Keywords

Antikoagülan/terapötik kullanım; artroplasti, replasman, kalça; artroplasti, replasman, diz; ameliyat sonrası komplikasyon; risk faktörü; tromboembolizm; venöz trombozis.

Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study

Year 2008, Volume: 42 Issue: 5, 322 - 327, 19.01.2009

Faik Altintas Hakan Gurbuz Bulent Erdemli Bulent Atilla Recep Ustaoglu Ugur Ozic Oner Savk Huseyin Bayram Recep Memik Isık Akgun Abdullah Gogus Fatih Pestilci Adnan Konal Mahmut Argun Irfan Ozturk Nevzat Dabak Omer Bilgen Erhan Serin Cetin Onder Aykın Simsek Remzi Tozun Hakan Kinik

Abstract

Objectives: We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS).
Methods: An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients.
Results: Risk factors for VTE were seen in 73.2% of the patents, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively.
Conclusion: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.

Keywords

Anticoagulants/therapeutic use, arthroplasty, replacement, hip, knee, postoperative complications, risk factors, thromboembolism, venous thrombosis

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Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Article
Authors	Faik Altintas This is me Hakan Gurbuz This is me Bulent Erdemli This is me Bulent Atilla This is me Recep Ustaoglu This is me Ugur Ozic This is me Oner Savk This is me Huseyin Bayram This is me Recep Memik This is me Isık Akgun This is me Abdullah Gogus This is me Fatih Pestilci This is me Adnan Konal This is me Mahmut Argun This is me Irfan Ozturk This is me Nevzat Dabak This is me Omer Bilgen This is me Erhan Serin This is me Cetin Onder This is me Aykın Simsek This is me Remzi Tozun This is me Hakan Kinik This is me
Publication Date	January 19, 2009
Published in Issue	Year 2008 Volume: 42 Issue: 5

Cite

APA	Altintas, F., Gurbuz, H., Erdemli, B., Atilla, B., et al. (2009). Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study. Acta Orthopaedica Et Traumatologica Turcica, 42(5), 322-327.
AMA	Altintas F, Gurbuz H, Erdemli B, Atilla B, Ustaoglu R, Ozic U, Savk O, Bayram H, Memik R, Akgun I, Gogus A, Pestilci F, Konal A, Argun M, Ozturk I, Dabak N, Bilgen O, Serin E, Onder C, Simsek A, Tozun R, Kinik H. Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study. Acta Orthopaedica et Traumatologica Turcica. January 2009;42(5):322-327.
Chicago	Altintas, Faik, Hakan Gurbuz, Bulent Erdemli, Bulent Atilla, Recep Ustaoglu, Ugur Ozic, Oner Savk, Huseyin Bayram, Recep Memik, Isık Akgun, Abdullah Gogus, Fatih Pestilci, Adnan Konal, Mahmut Argun, Irfan Ozturk, Nevzat Dabak, Omer Bilgen, Erhan Serin, Cetin Onder, Aykın Simsek, Remzi Tozun, and Hakan Kinik. “Venous Thromboembolism Prophylaxis in Major Orthopaedic Surgery: A Multicenter, Prospective, Observational Study”. Acta Orthopaedica Et Traumatologica Turcica 42, no. 5 (January 2009): 322-27.
EndNote	Altintas F, Gurbuz H, Erdemli B, Atilla B, Ustaoglu R, Ozic U, Savk O, Bayram H, Memik R, Akgun I, Gogus A, Pestilci F, Konal A, Argun M, Ozturk I, Dabak N, Bilgen O, Serin E, Onder C, Simsek A, Tozun R, Kinik H (January 1, 2009) Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study. Acta Orthopaedica et Traumatologica Turcica 42 5 322–327.
IEEE	F. Altintas, “Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study”, Acta Orthopaedica et Traumatologica Turcica, vol. 42, no. 5, pp. 322–327, 2009.
ISNAD	Altintas, Faik et al. “Venous Thromboembolism Prophylaxis in Major Orthopaedic Surgery: A Multicenter, Prospective, Observational Study”. Acta Orthopaedica et Traumatologica Turcica 42/5 (January 2009), 322-327.
JAMA	Altintas F, Gurbuz H, Erdemli B, Atilla B, Ustaoglu R, Ozic U, Savk O, Bayram H, Memik R, Akgun I, Gogus A, Pestilci F, Konal A, Argun M, Ozturk I, Dabak N, Bilgen O, Serin E, Onder C, Simsek A, Tozun R, Kinik H. Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study. Acta Orthopaedica et Traumatologica Turcica. 2009;42:322–327.
MLA	Altintas, Faik et al. “Venous Thromboembolism Prophylaxis in Major Orthopaedic Surgery: A Multicenter, Prospective, Observational Study”. Acta Orthopaedica Et Traumatologica Turcica, vol. 42, no. 5, 2009, pp. 322-7.
Vancouver	Altintas F, Gurbuz H, Erdemli B, Atilla B, Ustaoglu R, Ozic U, Savk O, Bayram H, Memik R, Akgun I, Gogus A, Pestilci F, Konal A, Argun M, Ozturk I, Dabak N, Bilgen O, Serin E, Onder C, Simsek A, Tozun R, Kinik H. Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study. Acta Orthopaedica et Traumatologica Turcica. 2009;42(5):322-7.