title: Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?
abstract: OBJECTIVE
  Pulmonary embolism (PE) is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital.
  
  
  METHODS
  Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair) between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT) were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities.
  
  
  RESULTS
  We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively) within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE.
  
  
  CONCLUSIONS
  Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age).
authors.affiliation: Ufuk University, Department of Chest Diseases, Ankara, Turkey. drevrimeylem@gmail.com
authors.forename: Evrim Eylem
authors.initials: EE
authors.lastname: Akpinar
authors.forename: Derya
authors.initials: D
authors.lastname: Hoşgün
authors.forename: Burak
authors.initials: B
authors.lastname: Akan
authors.forename: Can
authors.initials: C
authors.lastname: Ateş
authors.forename: Meral
authors.initials: M
authors.lastname: Gülhan
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin