Deep Vein Thrombosis Chemoprophylaxis Research Articles

High Altitude as a Risk Factor for Venous Thromboembolism in Tibial Plateau Fractures.

Background: Tibial plateau fractures are often significant injuries that can require complex surgical interventions with prolonged perioperative immobilization, thereby increasing the risk of developing venous thromboembolic (VTE) events, specifically, deep vein thrombosis (DVT) and pulmonary embolism (PE). Risk stratification is paramount for guiding VTE prophylaxis. Although high altitude has been suggested to create a prothrombotic state, virtually no studies have explored its clinical effects in lower extremity trauma. The purpose of this study was to compare surgical fixation of tibial plateau fractures at high and low altitudes and its effects on post-operative VTE development.Methods: The Truven MarketScan claims database was used to retrospectively identify patients who underwent surgical fixation of isolated and closed tibial plateau fractures using Current Procedural Terminology (CPT) codes over a 10-year period. Extraneous injuries were excluded using the International Classification of Diseases, 10th edition (ICD-10), and CPT codes. Patient demographics, comorbidities, and DVT chemoprophylaxis prescriptions were obtained. Patients were partitioned into high altitude (>4000 feet) or low altitude (<100 feet) cohorts based on the zip codes of their surgery locations. One-to-one matching and univariate analysis were used to assess and control any baseline discrepancies between cohorts; multivariate regression was then performed between cohorts to determine the odds ratios (OR) for developing VTEs post-operatively.Results: There were 7,832 patients included for analysis. There was no statistical difference between high and low altitude cohorts in developing VTEs within 30 days post-operatively. Higher altitudes were associated with increased odds of developing DVT (OR 1.21, p = 0.043) and PE (OR 1.27, p = 0.037) within 90 days post-operatively.Conclusions: Surgical fixation of tibial plateau fractures is associated with an increased risk of developing VTEs at high altitudes within 90 days post-operatively. Understanding such risk factors in specific orthopaedic patient populations is essential for optimizing DVT prophylaxis protocols. Further studies should investigate this relationship and the role of DVT prophylaxis regimens in this population.

Patterns and Distribution of Deep Vein Thrombosis and Its Effects on Clinical Outcomes After Opening-Wedge High Tibial Osteotomy.

Background:Although a few studies have reported the incidence of deep vein thrombosis (DVT) after opening-wedge high tibial osteotomy (OWHTO), previous studies focused only on symptomatic DVT. Information is lacking regarding the overall incidence of DVT after OWHTO, thrombus location, and the relationship between DVT and clinical outcome.Purpose:To determine the overall incidence of DVT and classify the location of DVT after OWHTO. We also determined whether significant differences in clinical improvement exist in patients with and without DVT at 6 months and at 2 years after OWHTO.Study Design:Case-control study; Level of evidence, 3.Methods:This study included 46 patients (47 knees) who underwent OWHTO. All patients were instructed to perform knee range of motion exercises and partial weightbearing after drain removal. None of the patients received a chemoprophylaxis for DVT except intermittent pneumatic compression. DVT was diagnosed using 128-row multidetector computed tomography performed before discharge on the fourth postoperative day. The location was classified into 6 segments in the distal portion (muscular and axial veins) and proximal portion (popliteal, femoral, and common femoral veins and veins located above the iliac vein). International Knee Documentation Committee (IKDC) score was assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years using a linear mixed model.Results:Although the incidence of symptomatic DVT was 8.5% (n = 4), the overall incidence of early DVT was 44.7% (n = 21). All DVTs were located in the distal portion of the lower extremity vein, and 76.2% of the DVTs were located in an axial vein. The IKDC scores were 33.6 ± 7.2 and 35.3 ± 9.1 (P = .910) preoperatively, 38.1 ± 5.6 and 40.6 ± 8.4 (P = .531) at 6 months after surgery, and 44.8 ± 6.9 and 45.9 ± 11.4 (P = .786) at 2 years after surgery in patients without and those with DVT, respectively.Conclusion:The overall incidence of early DVT after OWHTO was 44.7%. DVT after OWHTO was found particularly around the osteotomy site (76.2%). Patients with DVT did not have inferior short-term clinical outcomes after surgery.

Comparing Bleeding and Thrombotic Rates in Spine Surgery: An Analysis of 119 888 Patients.

Study Design:Retrospective, database review.Objectives:Examine the utilization rate of postoperative deep vein thrombosis (DVT) prophylaxis and compare the incidence and severity of bleeding and thrombotic complications in elective spine surgery patients.Methods:We utilized PearlDiver, a national orthopedics claims database. All patients who underwent elective spine surgery from 2007 to 2017 were included. Patients were stratified by the presence of DVT prophylaxis drug codes, then by comorbidities for postoperative bleeding/thrombosis. The severity of all bleeding and thrombotic complications in each cohort was studied, including the incidence of complications requiring operative washout, diagnosis of pulmonary embolism, intensive care unit admission, and mortality.Results:A total of 119 888 patients were included. The majority of patients (118 720, >99%) were not administered postoperative DVT chemoprophylaxis while a minority of patients (1168) were. The overall rates of bleeding and thrombotic complications within the population not receiving DVT prophylaxis were 1.96% and 2.45%, respectively (P < .001). The incidence of surgical intervention for a wound washout was 0.62% compared with 1.05% for pulmonary embolism (P < .001). Intensive care unit admission rates related to a wound washout procedure or pulmonary embolism also significantly differed (0.07% vs 0.34%, P < .001). There were no observed differences in mortality. When controlling for patient comorbidity, patients with atrial fibrillation, cancer, or a prior history of thrombotic complications experienced the greatest increased risks of postoperative thrombosis.Conclusions:DVT prophylaxis is not routinely utilized following elective spine procedures. We report that there exist specific populations which may receive benefit from these practices, although further study is necessary to determine optimal prevention strategies for both thrombotic and bleeding complications in spine surgery.

Randomized Trial of Deep Vein Thrombosis Chemoprophylaxis with Bemiparin and Enoxaparin in Patients with Moderate to High Thrombogenic Risk Undergoing Plastic and Reconstructive Surgery Procedures.

Deep vein thrombosis (DVT) is a common complication during postoperative convalescence characterized by hypercoagulability, vascular endothelium damage and blood stasis. It increases noticeably in peri/postoperative phases of surgery procedures. Pulmonary embolism secondary to iliofemoral DVT is a frequent cause of death. Adult patients scheduled for plastic and reconstructive surgery (PRSx) with moderate to high thrombogenic risk were selected. We evaluated the efficacy and safety of bemiparin compared to enoxaparin as chemoprophylaxis for DVT. Following balanced general anesthesia techniques, patients were randomly assigned for subcutaneous enoxaparin 40IU (Group-E) or bemiparin 3500IU (Group-B) q24h starting 6h after procedure conclusion for at least 10days. All patients were evaluated for DVT through Doppler ultrasound mapping of the lower limbs. Seventy-eight patients were evaluated, mostly women (83%), physical status ASA II (59%), ASA III (10%); Caprini's thrombogenic risk score 3-4 (moderate) 58%, 5-6 (high) 29%, > 6 (too high) 13%; demographics, clinical variables and scores were similar between groups. Median drainage time in breast surgery was 4days in both groups (p = 0.238). In the case of abdominal surgery, median was 14days in Group-E versus 13days in Group-B (p = 0.059). No DVT was detected in either group. DVT was prevented with bemiparin, without significant bleeding increase nor adverse events; moreover, the cost of bemiparin is lower than enoxaparin. Bemiparin can be considered as alternative drug for DVT chemoprophylaxis in PRSx procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Chemoprophylaxis for deep vein thrombosis after hip surgery: Clinical guidelines and treatment options

Chemoprophylaxis for deep vein thrombosis after hip surgery: Clinical guidelines and treatment options

OBTAIN E: outcome benefits of tranexamic acid in hip arthroplasty with enoxaparin: a randomised double-blinded controlled trial.

We examined the blood conserving effect of tranexamic acid in total hip arthroplasty using the direct anterior approach with enoxaparin as deep vein thrombosis (DVT) chemoprophylaxis, and whether this translates to an effect on functional outcomes in the perioperative period. We also compare the effect of aspirin and enoxaparin as DVT chemoprophylactic agents. We conducted a single-centre randomised, double-blinded, placebo-controlled trial. 105 patients were randomised to receive either tranexamic acid or an equivalent volume of normal saline with enoxaparin used as DVT chemoprophylaxis. The primary outcome measure was thigh swelling. Blood loss and the incidence of blood transfusions was also recorded. Secondary outcome measures including postoperative functional scores and mobility, pain scores and length of stay. We also compared and pooled the results of a previous study with the same study intervention methodology which used aspirin as DVT chemoprophylaxis instead of enoxaparin. There were no statistically significant differences between the primary outcome of thigh swelling. There was significantly less intraoperative blood loss observed in the tranexamic acid (TXA) group (0.510 L, SD 0.210) compared with the control group (0.698, SD 0.301) ( p < 0.001). The estimated blood loss was also significantly less in the TXA group (1.130 L, SD 0.311) compared with the control group (1.48 L, SD 0.510) ( p < 0.001). Pooled data of both consecutive trials showed there was a statistically significant reduction in length of stay for those that received TXA (3.72 days, SD 0.83 versus 4.24 days, SD 0.97, p < 0.001). There was also a statistically significant increased risk of a transfusion in the control group as compared those that received TXA (OR 5.5, 1.188 to 25.449, p = 0.029). There was no difference in blood loss between DVT chemoprophylactic agents. TXA is an effective agent in reducing blood loss in THR using the anterior approach and was not affected by choice of DVT chemoprophylaxis. Patients who received TXA had fewer transfusions and a reduction in their length of stay. The blood conserving effect of TXA was not associated with improved postoperative recovery across the measures of pain and mobility. ANZCTR number: ACTRN12616000606482.

Chemoprophylaxis for deep vein thrombosis after hip surgery: The Indian prospective

Background: Deep vein thrombosis (DVT) or venous thromboembolism is a fatal complication of patients undergoing elective hip surgeries. Not much evidence is provided in the Indian literature regarding the incidence of DVT in the Indian population and ideal prophylaxis for the same. This issue has gained much importance in recent history due to the increase in a number of elective hip surgeries. Low-molecular-weight (LMW) heparin is commonly used for chemoprophylaxis against DVT. Our study is to identify the role of LMW heparin (enoxaparin) for prophylaxis against DVT. Materials and Methods: The present study is a prospective study for the role of enoxaparin in prophylaxis against DVT in patients of elective hip surgeries carried out over a period of 2 years. A total of 110 patients were selected based on the stringent inclusion and exclusion criteria. Randomization was done and patients were divided into two groups of 55 patients each. Group 1 (case) received postoperative enoxaparin at a dose of 40 mg subcutaneous daily for 7 days whereas Group 2 (control) did not receive any prophylaxis, following which color Doppler was performed on all patients. Results: The overall incidence of DVT in our study group was found to be 23.6%, of which 61.5% had distal thrombus and 28.5% had thrombus in the proximal vein. The incidence of DVT in case group was 12.5% compared to control group, in which the incidence of DVT was found to be 34.5%; hence, statistically significant difference (P = 0.0071) in the incidence of DVT was found in both groups. Duration of surgery and patient's age were two most significant risk factors associated with the occurrence of DVT. No statistically significant difference was noted regarding postoperative bleeding complications between two groups (P > 0.05). Conclusion: DVT/venous thromboembolism is relatively less common in Indian patients following elective hip surgeries as compared to the Western population, and LMW heparin is a safe and effective method of prophylaxis against DVT.

Incidence and risk factors of deep vein thrombosis (DVT) after total hip or knee arthroplasty: a retrospective study with routinely applied venography.

Deep vein thrombosis (DVT) after total hip or knee arthroplasty is relatively common and is associated with significant morbidity and mortality, presenting a large clinical burden. The objective of this study was to investigate the incidence and risk factors for DVT after total joint arthroplasty. This retrospective review was conducted in a single institution. The patients received postoperative DVT chemoprophylaxis (Fraxiparine or Rivaroxaban), followed by venography to check for DVT on the third to ninth postoperative day. The clinical characteristics were summarized and analyzed using SPSS version 17.0. From March 2010 to July 2013, 963 patients were enrolled in the study. DVT chemoprophylaxis was administered to all of the 963 patients. DVT occurred in 173 subjects (17.96%). Univariate analysis showed that age (P < 0.001), BMI (P < 0.01), cholesterol (P < 0.001), high-density lipoprotein (P < 0.001), apolipoprotein A (P < 0.01), history of tumor (P < 0.05), visual analogue scale (VAS) pain score (P < 0.001), and operative duration (P < 0.05) were significant risk factors for DVT. The incidence of DVT was 17.96% after total joint arthroplasty with prophylactic antithrombotic therapy. Age, BMI, cholesterol, high-density lipoprotein, apolipoprotein A, history of tumor, VAS score, and operative duration were significant risk factors for DVT.

An analysis of deep vein thrombosis in burn patients (part II): A randomized and controlled study of thrombo-prophylaxis with low molecular weight heparin

IntroductionMorbidity and mortality from venous thrombo-embolism (VTE) remains a significant problem for trauma and medical patients and there are established guidelines for prophylaxis in these patients. However, the efficacy and safety of VTE prophylaxis in thermally injured patients continue to be elusive as it has never been studied in a prospective, randomized fashion. Selective use of VTE prophylaxis, for high risk patients, is practiced by some burn units even if objective evidence is lacking for majority of risk factors enunciated in burn patients. Differing demographics and wound management techniques are other confounding factors mandating more prospective studies to evaluate the need and role of chemoprophylaxis for deep vein thrombosis (DVT) prevention in burn patients. Ours is the first prospective, randomized, controlled study which seeks to identify risk factors for DVT in our patients, and evaluate the role of routine chemoprophylaxis and its complications. MethodsThe study design (sample size, inclusion/exclusion criteria, randomization, methodology and statistical methods) is detailed in part-1 of this two part manuscript. ResultsDoppler ultrasound (DUS) identified DVT in four out of 50 patients (8% incidence) forming the control group. DVT was not detected in any of the patients on prophylaxis (0% incidence). This difference was found to be statistically significant (p value—0.021). Patients with DVT had significantly higher %TBSA, prolonged immobility and a longer duration of stay as compared to patients without DVT in the control group. Only one patient on enoxaparin prophylaxis developed mild epistaxis which resolved spontaneously. Fifteen patients died during the study out of which two had DVT but none showed autopsy evidence of pulmonary embolism. ConclusionWith a moderate risk of developing DVT (8%) and a complication rate of only 2% with chemoprophylaxis, we feel that routine prophylaxis has the potential to decrease the incidence of VTE, without associated complications, in the moderate to high risk category.

Is pre-operative assessment of coagulation profile with Thrombelastography (TEG) useful in predicting venous thromboembolism (VTE) following orthopaedic surgery?

Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented. Diagnosis of DVT was made with Duplex ultrasonography. We also assessed the usefulness of pre-operative assessment of the hypercoagulable status of the patient in predicting the occurrence of VTE, using the Thrombelastography (TEG) test. The incidence of DVT in the study population was 7%. Six of the 7 patients who developed DVT had surgery for hip fractures, while one had knee replacement. The thrombus was above the knee joint level in 6 of the 7 patients. Pre-operative TEG was positive in only one of the 7 patients, but was positive in 37 of the remaining 94 patients. Incidence of DVT in the study population is sufficiently high to recommend some form of prophylaxis to prevent VTE following hip and knee surgery. Pre-operative assessment of the patients' coagulation status with Thrombelastography does not predict the risk of VTE. The use of other lab parameters that could help in selective chemoprophylaxis needs to be explored.

180 Early Deep Vein Thrombosis Chemoprophylaxis in Traumatic Brain Injury

180 Early Deep Vein Thrombosis Chemoprophylaxis in Traumatic Brain Injury

Independent Predictors of 30-Day Perioperative Deep Vein Thrombosis in 1346 Consecutive Patients After Spine Surgery

Deep vein thrombosis (DVT) is a morbid postsurgical complication. Identifying the perioperative DVT risk profile will improve surgeons' ability to assess patients for surgical candidacy. In addition, these data will help to identify patients who would benefit from DVT chemoprophylaxis. We evaluated all medical records for 1346 consecutive patients who underwent spinal surgery at Duke University for incidence of DVT within 30 days of surgery and documented all demographic, preoperative, operative, and postoperative variables. DVT treatment and long-term outcomes were also documented. Associations between postoperative DVT and individual risk factors in all patients were determined using adjusted logistic regression analysis. Patients were stratified into emergent and elective groups and a similar analysis was performed. Overall, 15 patients (1.1%) had a DVT in the 30 days after surgery, 7 patients (0.6%) after elective surgery and 8 patients (4.2%) after emergent surgery (P = 0.03). Overall, multivariate logistic regression determined that previous DVT, postoperative urinary tract infection, and creatinine level >2.0 mg/dL were identified as positive predictors. When stratified by emergent surgery, we found packed red blood cell transfusion, surgical blood loss >2.0 L, and deep surgical site infection to be independently associated with increased risk of postoperative DVT. When stratified by elective surgery, we found that coronary artery disease and atrial fibrillation were associated with increased risk of DVT. No patients died in the 30-day perioperative period and 5 (33.3%) patients died within 1 year. This study identifies patient factors predictive of postoperative DVT. Postoperative DVT prophylaxis may be warranted for patients undergoing emergent spine surgery because these patients have significantly higher risk of developing postoperative DVT.

PC180. Incidence and Clinical Characteristics of Deep Vein Thrombosis (DVT) After Total Knee Arthroplasty (TKA) with DVT Chemoprophylaxis

Objective: Deep vein thrombosis (DVT) after total knee arthroplasty (TKA) is very common and leading cause of death due to this procedure. The objective of this study was to investigate the in- cidence and clinical characteristics of DVT after TKA with DVT chemoprophylaxis. Methods: This is a prospective cohort study in single institution. The patients received postoperative DVT chemo- prophylaxis (low molecular weight heparin (LMWH) or Fondaparinux), followed by duplex ultra- sonography to check for DVT 1 - 2 weeks after TKA. The clinical characteristics were summarized and analysed by chi-square test and regression analysis. Results: Five hundred and thirty four pa- tients were enrolled from January 2007 to December 2010. DVT chemoprophylaxis was adminis- tered in 524 (98.1%) of the 534 patients. DVT occurred in 9 subjects (1.69%); 8 subjects had DVT in the leg, and 1 subject had a pulmonary embolism. Among them, asymptomatic DVT was ob- served in 5 patients (0.94%). Univariate analysis showed that surgical methods (revision, P = 0.0007), body mass index (BMI) (>25, P = 0.0028), low platelet count (less than 150 × 10 3 , P = 0.0219), time in the intensive care unit (ICU) (P < 0.0001), no administration of prophylactic LMWH (P = 0.0392), and a history of DVT (P < 0.0001) were significant risk factors of DVT. Conclu- sions: The incidence of DVT was 1.69% after TKA with prophylactic antithrombotic therapy. Revi- sion surgery, BMI, low platelet count, time in ICU, absence of prophylactic LMWH and history of DVT were significant risk factors of DVT. * Corresponding author.

Rivaroxaban‐induced Epidural Hematoma and Cauda Equina Syndrome after Total Knee Arthroplasty: a Case Report

Deep venous thrombosis and pulmonary embolism are a major cause of morbidity and mortality after arthroplasty. Chemoprophylaxis has been effective in reducing the incidence of symptomatic deep venous thrombosis, but not of pulmonary embolism, after total hip arthroplasty (THA) and total knee arthroplasty (TKA)1. Rivaroxaban, an orally administered factor Xa inhibitor, has recently been introduced for reducing the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee arthroplasty2, 3, 4, 5. Factor Xa catalyzes the conversion of prothrombin to thrombin. Because a single molecule of Xa can generate thousands of thrombin molecules, factor Xa is an excellent drug target6. In many ways, rivaroxaban is an ideal drug, being orally administered, usually requiring no monitoring and having a faster onset of action than warfarin. However, like other effective thromboprophylactic agents, rivaroxaban has been associated with an increased incidence of bleeding from surgical wounds or other sites. Here we present a case of a patient who developed a symptomatic epidural hematoma after postoperative administration of rivaroxaban. The patient was informed that we wanted to submit this case for publication and gave written permission. The purpose of this report was to describe an unanticipated, early complication of a new type of DVT chemoprophylaxis after total knee arthroplasty, thus educating patients and surgeons about the possible risks of chemoprophylaxis. This patient appeared to develop the complication while bridging from a different anticoagulant to rivaroxaban. We now recommend extreme caution re‐using rivaroxaban in the setting of recent spinal anesthesia after arthroplasty.

Incidence and Clinical Characteristics of Deep Vein Thrombosis (DVT) after Total Knee Arthroplasty (TKA) with DVT Chemoprophylaxis

Objective: Deep vein thrombosis (DVT) after total knee arthroplasty (TKA) is very common and leading cause of death due to this procedure. The objective of this study was to investigate the incidence and clinical characteristics of DVT after TKA with DVT chemoprophylaxis. Methods: This is a prospective cohort study in single institution. The patients received postoperative DVT chemoprophylaxis (low molecular weight heparin (LMWH) or Fondaparinux), followed by duplex ultrasonography to check for DVT 1 - 2 weeks after TKA. The clinical characteristics were summarized and analysed by chi-square test and regression analysis. Results: Five hundred and thirty four patients were enrolled from January 2007 to December 2010. DVT chemoprophylaxis was administered in 524 (98.1%) of the 534 patients. DVT occurred in 9 subjects (1.69%); 8 subjects had DVT in the leg, and 1 subject had a pulmonary embolism. Among them, asymptomatic DVT was observed in 5 patients (0.94%). Univariate analysis showed that surgical methods (revision, P = 0.0007), body mass index (BMI) (>25, P = 0.0028), low platelet count (less than 150 × 103, P = 0.0219), time in the intensive care unit (ICU) (P < 0.0001), no administration of prophylactic LMWH (P = 0.0392), and a history of DVT (P < 0.0001) were significant risk factors of DVT. Conclusions: The incidence of DVT was 1.69% after TKA with prophylactic antithrombotic therapy. Revision surgery, BMI, low platelet count, time in ICU, absence of prophylactic LMWH and history of DVT were significant risk factors of DVT.

The use of routine chemoprophylaxis for deep vein thrombosis in all patients undergoing hip and knee replacements in rural population - whether it is justified?

Background: Deep vein thrombosis (DVT)/ pulmonary embolism (PE) are one of the most feared complications in patients undergoing joint replacements in western literatures. The exact incidence of DVT in Indians particularly rural population remains debatable. Also ways to prevent it in rural population is a dilemma for the orthopedic community. Hence this study was undertaken. Methods: We carried a prospective study of 135 cases of joint replacements i.e. 78 of total hip replacements and 57 of total knee replacements. None of the patients were given any form of chemoprophylaxis like low molecular weight heparin (LMWH). Strict monitoring was done. All patients underwent duplex ultrasonographic doppler assessment of both the lower limbs between the 4th-7th day and on 14th - 16th postoperative day. Only 5 out of 135 cases had DVT. Results: We observed that DVT developed more commonly following total hip replacement surgery (4 cases) as compared to total knee replacement (1 case). There was no mortality in our study. Conclusions: DVT following total joint replacements in rural Indian patients is not as common as reported in the Western literature. A high level of suspicion and close clinical monitoring is mandatory. The use of routine chemoprophylaxis in every patient is perhaps not justified. In future further more trials with a larger number of patients and at multiple centers would be required to confirm the findings of our study and to formulate guidelines to prevent DVT.

Profilaxia medicamentosa da trombose venosa profunda em pacientes submetidos à cirurgia do trauma em um hospital universitário

CONTEXTO: Anualmente, milhões de pessoas são vítimas de trauma no mundo. Além de suas consequências sociais e econômicas, muitos dos pacientes necessitam de tratamento cirúrgico, gerando, portanto, maiores riscos à vida. O tromboembolismo venoso, consequência da trombose venosa profunda, é uma importante causa de morbimortalidade em pós-operatórios e pode ser evitado com profilaxia adequada. OBJETIVO: Avaliar a utilização da profilaxia medicamentosa para trombose venosa profunda em pacientes submetidos à cirurgia do trauma de emergência, em um hospital-escola. MÉTODOS: Estudo transversal analítico, com 153 pacientes internados no Hospital Universitário Cajuru, em Curitiba, no Paraná, durante dois meses. Foram analisados prospectivamente prontuários de pacientes que necessitaram de cirurgia devido a trauma. O estudo incluiu pacientes classificados como alto e médio risco para trombose venosa profunda e avaliou-se a realização, ou não, da profilaxia medicamentosa. A análise estatística foi feita de forma descritiva. RESULTADOS: Dos 153 pacientes incluídos no estudo, 99 (64,7%) foram classificados como alto risco para trombose venosa e 54 (35,3%) como médio, sendo que 144 (94%) não receberam profilaxia medicamentosa. Dos nove (6%) pacientes que receberam profilaxia medicamentosa, um foi estratificado como médio risco e os outros oito de alto risco. Dos pacientes que receberam profilaxia, em apenas quatro a orientação foi adequada. CONCLUSÕES: A profilaxia para trombose venosa não é realizada de maneira rotineira nos pacientes de médio e alto risco para trombose venosa profunda que são submetidos à cirurgia do trauma e, quando realizada, muitas vezes é inadequada.

Routine chemoprophylaxis for deep vein thrombosis in Indian patients: Is it really justified?

Routine chemoprophylaxis for deep vein thrombosis in Indian patients: Is it really justified?