The incidence of symptomatic venous thromboembolic events in orthopaedic surgery when using routine thromboprophylaxis.
BACKGROUND
Few studies have shown the effect of thromboprophylactic regimen with low molecular weight heparin (LMWH) on the incidence of clinical venous thromboembolism (VTE) in common practice. The aim was to study the three-year incidence of clinically overt VTE events at a university based orthopaedic department with some 3300 operations performed and 15 000 patients treated annually.


METHODS
Since all Swedish citizens have an individual identification number it was possible tp follow up all patients operated during a 3 year period (2000-2002) for a period of four months.


RESULTS
The incidence of VTE in the classical high-risk groups of hip fracture surgery, total hip arthroplasty (THA) and total knee arthroplasty (TKA) was low - about 0.6 %, while the Pulmonary embolism (PE) incidence in the hip fracture group was 0.27%, with two cases of fatal PE occurring 72 and 109 days after surgery. Patients with ankle fractures had more VTE. The majority of clinical VTE occurred after discharge from hospital.


CONCLUSIONS
When using routine thrombopropylaxis with LMWH in orthopaedic surgery the rate of symptomatic VTE is low.
Milbrink
J
J
Department of Orthopaedics, University Hospital, Uppsala, Sweden.
Bergqvist
D
D
D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight