A Comparison of Discharge and Two-Week Duplex Ultrasound Screening Protocols for Deep Venous Thrombosis Detection Following Primary Total Joint Arthroplasty

DHUPAR, SCOTT; Iorio, Richard; Healy, William L.; Dhimitri, Kenneth

doi:10.2106/00004623-200611000-00009

Cited by 5 publications

(6 citation statements)

References 22 publications

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“…Concern about the potential risk for pulmonary embolism as a result of asymptomatic deep venous thrombosis has led clinicians to consider performing routine screening tests to diagnose asymptomatic venous thrombosis especially in high-risk adult patients (15,16). But, surveillance scanning did not enable reliable prediction of pulmonary embolism in adult orthopedic surgery (17).…”

Section: Discussionmentioning

confidence: 99%

Screening for deep venous thrombosis after idiopathic scoliosis surgery in children: a pilot study

Kaabachi¹,

Alkaissi

Koubaa³

et al. 2010

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Screening for deep venous thrombosis after idiopathic scoliosis surgery in children: a pilot study

Kaabachi¹,

Alkaissi

Koubaa³

et al. 2010

Pediatric Anesthesia

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“…It is also possible that some of the PEs recorded were found incidentally or not actually clinically relevant, but due to different management protocols certain centers are more likely to order additional studies to evaluate a patient postoperatively. [21][22][23] For instance, if by chance there are several high elevation centers that happen to have a lower threshold for ordering duplex ultrasound then these centers would inherently have higher rates of VTEs in that they were actively looking for them at a more frequent rate. Unfortunately, our methods and data does not allow us to identify which patients or centers obtained imaging studies to aid the diagnosis.…”

Section: Possible Causesmentioning

confidence: 99%

High Altitude Is an Independent Risk Factor for Developing a Pulmonary Embolism, but Not a Deep Vein Thrombosis Following a 1- to 2-Level Lumbar Fusion

Donnally

Vakharia

Sheu

et al. 2019

Global Spine Journal

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Study Design: Retrospective study. Objective: To identify if a 1- to 2-level posterior lumbar fusion at higher altitude is an independent risk factor for postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods: A national Medicare database was queried for all patients undergoing 1- to 2-level lumbar fusions from 2005 to 2014. Those with a prior history of DVT, PE, coagulopathy, or peripheral vascular complications were excluded to better isolate altitude as the dependent variable. The groups were matched 1:1 based on age, gender, and comorbidities to limit potential cofounders. Using ZIP codes of the hospitals where the procedure occurred, we separated our patients into high (>4000 feet) and low (<100 feet) altitudes to investigate postoperative rates of DVTs and PEs at 90 days. Results: Compared with lumbar fusions performed at low-altitude centers, patients undergoing the same procedure at high altitude had significantly higher PE rates ( P = .010) at 90 days postoperatively, and similar rates of 90-day postoperative DVTs ( P = .078). There were no significant differences in age or comorbidities between these cohorts due to our strict matching process ( P = 1.00). Conclusion: Spinal fusions performed at altitudes >4000 feet incurred higher PE rates in the first 90 days compared with patients receiving the same surgery at <100 feet but did not incur higher rates of postoperative DVTs.

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“…16,[27][28][29][30][31][32] VTEs can result in a high degree of morbidity and/or mortality related to pelvic and lower-limb deep vein thrombosis (DVT) and pulmonary embolism (PE). 8,[26][27][28]31,[33][34][35][36][37] Without prophylaxis, VTE has an estimated incidence of 40 to 60%, 3,17,[38][39][40] and an event rate warranting medical attention of 1.6 to 6.4%. 8,27,38,40,41 Stratification of the risks to identify patients most in need of vigilant monitoring or aggressive prophylactic therapy has been undertaken.…”

Section: Venous Thromboembolic Eventsmentioning

confidence: 99%

“…Recommendations for the duration of anti-VTE therapy vary from 14 to 42 days, 8,27,28,32,33,37,41,42,[49][50][51][52][53][54] but their translation into clinical practice has been inconsistent. 5,14,49,55,56 After THR, a thromboprophylactic regimen of >14 days has been advocated by many international bodies.…”

Section: Extended Course Of Thromboprophy-laxismentioning

confidence: 99%

Review Article: Thromboprophylaxis after Total Hip Replacement

Kurmis

2010

J Orthop Surg (Hong Kong)

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The risk of secondary haematologic complications such as deep vein thrombosis or pulmonary embolism increases significantly when a transient period of hypercoagulability is induced after total hip replacement (THR). A number of drug-based anticoagulant approaches are available to modulate this risk, but the optimal length of therapy for such approaches remains unclear. The literature was reviewed for evidence-based support of the routine use of an extended course (>14 days) of thromboprophylaxis after THR. Electronic databases and real-time online literature searches were performed, using the PubMed (Medline), EMBASE, CINAHL and GoogleScholar, and the Cochrane and British Medical Journal Clinical Evidence libraries. Author-defined key word searches were performed. Only articles in the English language, for which full text could be retrieved, were reviewed. There is robust evidence to support an extended course (>14 days) of thromboprophylaxis after THR. Such recommendations have been translated into the guidelines of key professional bodies, including those of the American College of Chest Physicians. Meta-review suggests a clear benefit of such regimens and supports wider adoption, even when weighed against a small increase in adverse events.

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A Comparison of Discharge and Two-Week Duplex Ultrasound Screening Protocols for Deep Venous Thrombosis Detection Following Primary Total Joint Arthroplasty

Cited by 5 publications

References 22 publications

Screening for deep venous thrombosis after idiopathic scoliosis surgery in children: a pilot study

Screening for deep venous thrombosis after idiopathic scoliosis surgery in children: a pilot study

High Altitude Is an Independent Risk Factor for Developing a Pulmonary Embolism, but Not a Deep Vein Thrombosis Following a 1- to 2-Level Lumbar Fusion

Review Article: Thromboprophylaxis after Total Hip Replacement

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