title: [Venous thromboembolism prophylaxis in major orthopaedic surgery: A multicenter, prospective, observational study].
abstract: OBJECTIVE
  We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS).
  
  
  METHODS
  An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients.
  
  
  RESULTS
  Risk factors for VTE were seen in 73.2% of the patients, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively.
  
  
  CONCLUSIONS
  Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.
authors.affiliation: Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Yeditepe University, Istanbul, Turkey. faltintas@yeditepe.edu.tr
authors.forename: Faik
authors.initials: F
authors.lastname: Altintaş
authors.forename: Hakan
authors.initials: H
authors.lastname: Gürbüz
authors.forename: Bülent
authors.initials: B
authors.lastname: Erdemli
authors.forename: Bülent
authors.initials: B
authors.lastname: Atilla
authors.forename: Recep Gür
authors.initials: RG
authors.lastname: Ustaoğlu
authors.forename: Uğur
authors.initials: U
authors.lastname: Oziç
authors.forename: Oner
authors.initials: O
authors.lastname: Savk
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Bayram
authors.forename: Recep
authors.initials: R
authors.lastname: Memik
authors.forename: Işik
authors.initials: I
authors.lastname: Akgün
authors.forename: Abdullah
authors.initials: A
authors.lastname: Göğüş
authors.forename: Fatih
authors.initials: F
authors.lastname: Pestilci
authors.forename: Adnan
authors.initials: A
authors.lastname: Konal
authors.forename: Mahmut
authors.initials: M
authors.lastname: Argün
authors.forename: Irfan
authors.initials: I
authors.lastname: Oztürk
authors.forename: Nevzat
authors.initials: N
authors.lastname: Dabak
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Bilgen
authors.forename: Erhan
authors.initials: E
authors.lastname: Serin
authors.forename: Cetin
authors.initials: C
authors.lastname: Onder
authors.forename: Aykin
authors.initials: A
authors.lastname: Simşek
authors.forename: Remzi
authors.initials: R
authors.lastname: Tözün
authors.forename: Hakan
authors.initials: H
authors.lastname: Kinik
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D005260:Female; D000077425:Fondaparinux; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011134:Polysaccharides / Q000627:therapeutic use; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D011134:Polysaccharides; D000077425:Fondaparinux