title: Implementing National Institute of Clinical Excellence guidelines for venous thromboembolism prophylaxis.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a serious complication after lower limb injury and surgery. Pursuing prophylactic policies, particularly chemical prophylaxis, has been a debatable issue. In April 2007, the National Institute of Clinical Excellence recommended using chemical and/or mechanical prophylaxis for patients undergoing joint arthroplasty and other orthopedic operations. A list of risk factors predisposing patients to VTE was published. This article discusses the difficulties and methods of implementing the guidelines.
  
  
  METHODS
  Patients undergoing lower limb arthroplasty or treatment for femoral neck fractures were included. In total, 9893 patients required prophylactic treatment for VTE.
  
  
  RESULTS
  The maximum readmission rate within 3 months of lower limb arthroplasty with a deep vein thrombosis or pulmonary embolism was reduced from 70% in 2005 to 28% in 2009.
  
  
  CONCLUSIONS
  The incidence of VTE was reduced to one fifth of that before implementing the National Institute of Clinical Excellence guidelines. Thus, it has been valuable to implement the guidelines.
authors.affiliation: Airedale NHS Foundation Hospital, Steeton, West Yorkshire, England. Electronic address: shevanfaraj@hotmail.com.
authors.forename: Adnan Abdilmajeed
authors.initials: AA
authors.lastname: Faraj
mesh_terms: D006801:Humans; D009985:Orthopedics / Q000379:methods* / Q000639:trends; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D006113:United Kingdom; D054556:Venous Thromboembolism / Q000517:prevention & control*