Effective VTE prophylaxis with enoxaparin after elective THR or TKR: a retrospective observational study

Abstract

Background: Orthopedic patients are at the highest risk for venous thromboembolism (VTE). Nowadays, with VTE prophylaxis as a routine in patients undergoing total hip replacement (THR) and total knee replacement (TKR), fatal pulmonary embolism (PE) is rare and the rates of symptomatic VTE within 3 months dropped to 1.3%–10%, compared with the rates of 50%–70% before VTE prophylaxis implementation. In this study, we aim to evaluate the VTE prophylaxis and incidence in patients who underwent THR and TKR in Centro Hospitalar Universitário de Santo António (CHUdSA). Methods: We included 483 patients who underwent elective THR or TKR in CHUdSA from March 2019 to February 2020 and who were under enoxaparin as a VTE prophylaxis drug. All data related to prescribed enoxaparin were collected from the nationwide common electronic drug prescription system (PEM). Results: Of the 483 eligible patients, 192 (39.75%) underwent elective THR and 291 (60.25%) underwent TKR. Enoxaparin was prescribed for 31.86 ± 5.98 and 30.28 ± 5.97 days, on average, for the THR and TKR groups, respectively (P = .005). Patients completed, on average, 29.38 ± 8.12 days and 28.20 ± 7.32 days of VTE prophylaxis with enoxaparin in the THR and TKR groups, respectively (P = .098). The incidence of VTE was approximately 3.13% and 0.69% in the THR and TKR groups, respectively (P = .064). Conclusion: In CHUdSA, we usually prescribe enoxaparin 40 mg once daily for up to 35 days for VTE prophylaxis after THR or TKR. High therapeutic compliance rates resulted in very few events.

Association Between Venous Thromboembolism Prophylaxis and the Incidence of Thromboembolism Following Orthopedic Procedures: A Cross-Sectional Study

“…Our study's outcomes both align with and extend the conclusions drawn from several prior investigations. For instance, the retrospective observational study by Nóbrega Catelas et al examined VTE prophylaxis and incidence in patients undergoing total hip and knee replacements, highlighting a noteworthy reduction in symptomatic VTE rates post-implementation of prophylaxis measures, a trend consistent with our own observations [ 14 ]. Similarly, the emphasis placed by Majima et al on the critical importance of preventing VTE after major orthopedic surgeries reinforces our study's focus on VTE prevention strategies [ 15 ].…”