Journal ArticleDOI
Prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty
Norman A. Johanson,Paul F. Lachiewicz,Jay R. Lieberman,Paul A. Lotke,Javad Parvizi,Vincent D. Pellegrini,Theodore A. Stringer,Paul Tornetta,Robert H. Haralson,William C. Watters +9 more
TLDR
This clinical practice guideline is based on a systematic review of published studies on the management of adult patients undergoing total hip replacement or total knee replacement aimed specifically at preventing symptomatic pulmonary embolism (PE).Abstract:
This clinical practice guideline is based on a systematic review of published studies on the management of adult patients undergoing total hip replacement (THR) or total knee replacement (TKR) aimed specifically at preventing symptomatic pulmonary embolism (PE). The guideline emphasizes the need to assess the patient's risk for both PE and postoperative bleeding. Mechanical prophylaxis and early mobilization are recommended for all patients. Chemoprophylactic agents were evaluated using a systematic literature review. Forty-two studies met eligibility criteria, of which 23 included patients who had TKR and 25 included patients who had THR. The following statements summarize the recommendations for chemoprophylaxis: Patients at standard risk of both PE and major bleeding should be considered for aspirin, low-molecular-weight heparin (LMWH), synthetic pentasaccharides, or warfarin with an international normalized ratio (INR) goal of < or =2.0. Patients at elevated (above standard) risk of PE and at standard risk of major bleeding should be considered for LMWH, synthetic pentasaccharides, or warfarin with an INR goal of < or =2.0. Patients at standard risk of PE and at elevated (above standard) risk of major bleeding should be considered for aspirin, warfarin with an INR goal of < or =2.0, or none. Patients at elevated (above standard) risk of both PE and major bleeding should be considered for aspirin, warfarin with an INR goal of < or =2.0, or none.read more
Citations
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Journal ArticleDOI
Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty.
Michael A. Mont,Joshua J. Jacobs,Lisa N. Boggio,Kevin J. Bozic,Craig J.Delia Valle,Stuart B. Goodman,Courtland G. Lewis,Adolph J. Yates,William C. Watters,Charles M. Turkelson,Janet L. Wies,Patrick Donnelly,Nilay Patel,Patrick Sluka +13 more
TL;DR: Early mobilization for patients following elective hip and knee arthroplasty is recommended and no clear evidence was established regarding whether inferior vena cava filters can prevent pulmonary embolism in patients who have a contraindication to chemoprophylaxis and/or known VTED.
Journal ArticleDOI
AAOS clinical practice guideline: preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty.
Michael A. Mont,Joshua J. Jacobs +1 more
Journal ArticleDOI
Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty
TL;DR: Group A anticoagulants were associated with the highest all-cause mortality of the three modalities studied, and clinical pulmonary embolus occurs despite the use of anticoAGulants.
Journal Article
Thrombosis Prevention After Total Hip Arthroplasty A Prospective, Randomized Trial Comparing a Mobile Compression Device with Low-Molecular-Weight Heparin
CliffordW. Colwell,Mark I. Froimson,Michael A. Mont,Merrill A. Ritter,Robert T. Trousdale,Knute C. Buehler,Andrew I. Spitzer,Thomas K. Donaldson,Douglas E. Padgett,勘武生(译) +9 more
TL;DR: When compared with low-molecular-weight heparin, use of the mobile compression device for prophylaxis against venous thromboembolic events following total hip arthroplasty resulted in a significant decrease in major bleeding events.
Journal ArticleDOI
Thrombosis Prevention After Total Hip Arthroplasty: A Prospective, Randomized Trial Comparing a Mobile Compression Device with Low-Molecular-Weight Heparin
Clifford W. Colwell,Mark I. Froimson,Michael A. Mont,Merrill A. Ritter,Robert T. Trousdale,Knute C. Buehler,Andrew I. Spitzer,Thomas K. Donaldson,Douglas E. Padgett +8 more
TL;DR: In this paper, the authors compared a new mobile compression device with low-molecular-weight heparin with regard to their safety and effectiveness for the prevention of venous thromboembolic disease.
References
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Journal ArticleDOI
Hemorrhagic Complications of Anticoagulant Treatment
TL;DR: There is good evidence that low-intensity oral anticoagulant therapy (targeted INR of 2.5; range, 2.0 to 3.0) is associated with a lower risk of bleeding than therapy targeted at a higher intensity, and Lower-intensity regimens (INR 70 years).
Journal ArticleDOI
Postoperative fondaparinux versus postoperative enoxaparin for prevention of venous thromboembolism after elective hip-replacement surgery: a randomised double-blind trial
TL;DR: In patients undergoing elective hip-replacement surgery, 2.5 mg fondaparinux once daily was not significantly more effective than 30 mg enoxaparin twice daily in reducing risk of venous thromboembolism, however, the lower risk recorded with fondAParinux than enoxamarin was clinically important, with no increase in clinically relevant bleeding.
Journal ArticleDOI
Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement.
Charlotte B. Phillips,Jane Barrett,Elena Losina,Nizar N. Mahomed,Elizabeth A. Lingard,Edward Guadagnoli,Edward Guadagnoli,John A. Baron,William H. Harris,William H. Harris,Robert Poss,Jeffrey N. Katz +11 more
TL;DR: The incidence rates of dislocation, pulmonary embolism, and deep infection are highest immediately after total hip replacement, but they continue to be elevated throughout the first three postoperative months.
Journal ArticleDOI
Hemorrhagic Complications of Anticoagulant Treatment: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
TL;DR: There is good evidence that vitamin K antagonist therapy, targeted international normalized ratio (INR) of 2.5 (range, 2.0 to 3.0), is associated with a lower risk of bleeding than therapy targeted at an INR >3.0.
Journal ArticleDOI
Thromboembolism after trauma: an analysis of 1602 episodes from the American College of Surgeons National Trauma Data Bank.
TL;DR: Patients who need VTEProphylaxis after trauma can be identified based on risk factors, and the use of prophylactic vena cava filters should be re-examined.