title: [Prophylaxis of venous thromboembolic disease in high-risk orthopedic surgery].
abstract: Venous thromboembolism (VTE) is a worldwide public health problem, with an annual incidence of 1-2 cases/1,000 individuals in the general population and a 1-5% associated mortality. Orthopedic surgery is a major surgical risk factor for VTE, but the problem is more important for patients with hip and knee joint replacement, multiple traumatisms, severe damage to the spine, or large fractures. Thromboprophylaxis is defined as the strategy and actions necessary to diminish the risk of VTE in high-risk orthopedic surgery. Antithrombotics may prevent VTE. At the end of this paper, we describe a proposal of thromboprophylaxis actions for patients requiring high-risk orthopedic surgery, based on the opinion of specialists in Orthopedics and Traumatology who work with high-risk orthopedic surgery patients. A search for evidence about this kind of surgery was performed and a 100-item inquiring instrument was done in order to know the opinions of the participants. Then, recommendations and considerations were built. In conclusion, this document reviews the problem of VTE in high-risk orthopedic surgery patients and describes the position of the Colegio Mexicano de Ortopedia y Traumatología related to VTE prevention in this setting.
authors.affiliation: Instituto Mexicano del Seguro Social, México.
authors.forename: Gilberto Eduardo
authors.initials: GE
authors.lastname: Meza Reyes
authors.forename: Ricardo
authors.initials: R
authors.lastname: Esquivel Gómez
authors.forename: Antonio
authors.initials: A
authors.lastname: Martínez del Campo Sánchez
authors.forename: Francisco
authors.initials: F
authors.lastname: Espinosa-Larrañaga
authors.forename: Miguel Ángel Enrique
authors.initials: MÁ
authors.lastname: Martínez Guzmán
authors.forename: Rubén
authors.initials: R
authors.lastname: Torres González
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: de la Fuente Zuno
authors.forename: Juan Vicente
authors.initials: JV
authors.lastname: Méndez Huerta
authors.forename: Enrique
authors.initials: E
authors.lastname: Villalobos Garduño
authors.forename: José
authors.initials: J
authors.lastname: Cymet Ramírez
authors.forename: Efrén
authors.initials: E
authors.lastname: Ibarra Hirales
authors.forename: Efraín
authors.initials: E
authors.lastname: Díaz Borjón
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Aguilera Zepeda
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Valles Figueroa
authors.forename: Abraham
authors.initials: A
authors.lastname: Majluf-Cruz
mesh_terms: D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects*; D012306:Risk; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology* / Q000517:prevention & control*