[Thrombosis prevention in orthopaedic surgery: clinical practice in the Netherlands in 2002].
OBJECTIVE
Establish the use of thromboprophylaxis in orthopaedic surgery both during and after the hospital admission.


METHODS
Cross-sectional study.


METHODS
In April 2002, a letter was sent to all orthopaedic surgeons in the Netherlands announcing that at every hospital with a Department of Orthopaedic Surgery, an orthopaedic surgeon would be approached for a telephone survey. They were phoned in the months April-June 2002. This study included hospitals where major orthopaedic surgery (e.g. the insertion of hip or knee prostheses and hip fracture surgery) took place (n = 124) as well as clinics that only performed day treatments (n = 5).


RESULTS
For major orthopaedic operations, 91% of the hospitals used low molecular weight heparin (LMWH) during the admission period: 36% as monotherapy and 55% in combination with coumarin derivates. In 85% of cases the use of LMWH was started preoperatively. Coumarin derivates were used as a monotherapy in 9% of the hospitals. In 37% of the hospitals the use of NSAIDs was continued, particularly in patients with rheumatoid arthritis. In 94% of the hospitals, the use of acetylsalicylic acid was always stopped. In 97% of the hospitals prophylaxis was given after discharge in the form of LMWH (37% of the cases) or coumarin derivates (63% of the cases). The use of thromboprophylaxis with respect to arthroscopies and plaster immobilisation was variable.
Schonenberg
D
D
Afd. Reumatologie, VU Medisch Centrum, Postbus 7057, 1007 MB Amsterdam.
van Meeteren
M
M
Nelissen
R G
RG
van der Horst-Bruinsma
I E
IE
Pöll
R G
RG
Nurmohamed
M T
MT
D000925:Anticoagulants / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D009426:Netherlands; D009985:Orthopedics / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D013927:Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight