title: Performance of new anticoagulants for thromboprophylaxis in patients undergoing hip and knee replacement surgery.
abstract: Venous thromboembolism (VTE) represents one of the most preventable complications that occur during hospitalization, and measurement of hospital-associated VTE is becoming a key component in hospital quality measures. Guidelines for the prevention of deep vein thrombosis and pulmonary embolism have been published by several organizations to guide quality of care; however, some of the guidelines are divergent in their recommendations. This disagreement among guidelines is most pronounced in patients undergoing major orthopedic surgery. The advent of newer anticoagulants, which are now approved or in late-phase development, have already had an effect on the guidelines and may also affect quality measures in the future. In this article, we review the burden of VTE in patients undergoing major orthopedic surgery, highlight the differences in the guidelines, and examine the new anticoagulants as they are related to VTE prophylaxis in this patient group.
authors.affiliation: Department of Outcomes Research, New Mexico Heart Institute, University of New Mexico, 502 Elm Street NE, Albuquerque, NM 87102, USA. cmahan@nmhi.com
authors.forename: Charles E
authors.initials: CE
authors.lastname: Mahan
authors.forename: Scott
authors.initials: S
authors.lastname: Kaatz
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D000069604:Dabigatran; D019317:Evidence-Based Medicine; D006801:Humans; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011720:Pyrazoles / Q000009:adverse effects / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use; D000069552:Rivaroxaban; D012955:Societies, Medical; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D015091:beta-Alanine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D009025:Morpholines; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; D013876:Thiophenes; D015091:beta-Alanine; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran; C552171:edoxaban