Τίτλος:
Thromboembolism prophylaxis in orthopaedics: An update
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
▪ Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death. ▪ Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%. ▪ VTE prophylaxis methods are divided into mechanical and pharmacological. The former include mobilization, graduated compression stockings, intermittent pneumatic compression device and venous foot pumps; the latter include aspirin, unfractionated heparin, low molecular weight heparin (LMWH), adjusted dose vitamin K antagonists, synthetic pentasaccharid factor Xa inhibitor (fondaparinux) and newer oral anticoagulants. LMWH seems to be more efficient overall compared with the other available agents. We remain sceptical about the use of aspirin as a sole method of prophylaxis in total hip and knee replacement and hip fracture surgery, while controversy still exists regarding the use of VTE prophylaxis in knee arthroscopy, lower leg injuries and upper extremity surgery. © 2018 The author(s).
Συγγραφείς:
Flevas, D.A.
Megaloikonomos, P.D.
Dimopoulos, L.
Mitsiokapa, E.
Koulouvaris, P.
Mavrogenis, A.F.
Περιοδικό:
EFORT Open Reviews
Εκδότης:
British Editorial Society of Bone and Joint Surgery
Λέξεις-κλειδιά:
acetylsalicylic acid; antithrombocytic agent; antivitamin K; apixaban; dabigatran; fondaparinux; heparin; low molecular weight heparin; rivaroxaban, Article; drug effect; drug efficacy; drug response; elective surgery; fracture treatment; hip fracture; hip replacement; human; incidence; knee arthroscopy; knee replacement; leg injury; orthopedics; patient risk; practice guideline; priority journal; risk factor; spinal cord injury; spine surgery; treatment outcome; venous thromboembolism
DOI:
10.1302/2058-5241.3.170018
