Bleeding complications after systematic switch of routine thromboprophylaxis for major orthopaedic surgery

SummaryThe rate of bleeding complications after major orthopedic surgery approximates 2%. It is unclear whether a systematic switch of routine thromboprophylaxis has an impact on the rate of postoperative bleeding complications. We analyzed prospectively recorded postoperative bleeding complications and symptomatic venous thromboembolic events in 8,176 consecutive orthopedic patients at the Schulthess Clinic Zurich during a systematic switch of thromboprophylaxis from nadroparin to enoxaparin in the year 2004. Overall, 3,893 patients received nadroparin in the first nine-month observation period before the switch and 4,283 patients received enoxaparin in the second nine-month observation period after the switch. Overall, 96 (2.5%) patients in the first period and 70 (1.6%) patients in the second period suffered a postoperative bleeding complication requiring surgical revision, puncture, or transfusion (p<0.01). Five objectively confirmed symptomatic venous thromboembolic events during hospitalization in the first period and three events in the second period were recorded. In conclusion, the switch of thromboprophylaxis in a large orthopedic clinic did not cause an increase of postoperative bleeding complications and therefore was accompanied by high patient safety.

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PCV114 DABIGATRAN ETEXILATE IS COST-SAVING FOR THE PRIMARY PREVENTION OF VENOUS THROMBOEMBOLIC EVENTS FOLLOWING MAJOR ORTHOPAEDIC SURGERY IN THE NETHERLANDS

Value in Health ◽

10.1016/s1098-3015(10)74641-6 ◽

2009 ◽

Vol 12 (7) ◽

pp. A334 ◽

Cited By ~ 3

Author(s):

C Boersma ◽

BS Kappelhoff ◽

MJ Postma

Keyword(s):

Primary Prevention ◽

The Netherlands ◽

Cost Saving ◽

Orthopaedic Surgery ◽

Dabigatran Etexilate ◽

Thromboembolic Events ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Major Orthopaedic Surgery

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Combined assessment of thrombotic and haemorrhagic risk in acute medical patients

Thrombosis and Haemostasis ◽

10.1160/th14-12-1050 ◽

2016 ◽

Vol 115 (02) ◽

pp. 392-398 ◽

Cited By ~ 11

Author(s):

Francesco Orlandini ◽

Francesca Marchini ◽

Alessia Marinaro ◽

Rosanna Bonacci ◽

Paola Bonanni ◽

...

Keyword(s):

Internal Medicine ◽

Multivariate Analysis ◽

High Risk ◽

Bleeding Complications ◽

Thromboembolic Events ◽

Medical Patients ◽

Pharmacological Prophylaxis ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Supplementary Material

SummaryAcute medical patients have a high risk of venous thromboembolic events (VTE). Unfortunately, the fear of bleeding complications limits the use of antithrombotic prophylaxis in this setting. To stratify the VTE and haemorrhagic risk, two clinical scores (PADUA, IMPROVE) have recently been developed. However, it is not clear how many patients have a concomitant high VTE and haemorrhagic risk and what is the use of prophylaxis in this situation. To clarify these issues we performed a prospective cohort study enrolling consecutive patients admitted to internal medicine. Patients admitted to internal medicine (January to December 2013) were included. VTE and haemorrhagic risk were evaluated in all the included patients. Use and type of anti-thrombotic prophylaxis was recorded. A total of 1761 patients (mean age 77.6 years) were enrolled; 76.8 % (95 % CI 74.7–78.7) were at high VTE risk and 11.9 % (95 % CI 10.4–13.5) were at high haemorrhagic risk. Anti-thrombotic prophylaxis was used in 80.5 % of patients at high VTE risk and in 6.5 % at low VTE risk (p< 0.001), and in 16.6 % at high haemorrhagic risk and in 72.5 % at low haemorrhagic risk (p< 0.001). Prophylaxis was used in 20.4 % at both high VTE and haemorrhagic risk and in 88.9 % at high VTE risk but low haemor-rhagic risk. At multivariate-analysis, use of prophylaxis appeared highly influenced by the VTE risk (OR 68.2, 95 % CI 43.1 - 108.0). In conclusion, many patients admitted to internal medicine were at high risk of VTE. Since almost 90 % of them were at low haemorrhagic risk, pharmacological prophylaxis may be safely prescribed in most of these patients.Supplementary Material to this article is available online at www.thrombosis-online.com.

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DOES APPROPRIATE VENOUS THROMBOEMBOLIC PROPHYLAXIS DECREASE VENOUS THROMBOEMBOLIC EVENTS OR RESULT IN INCREASED BLEEDING COMPLICATIONS IN TRAUMA PATIENTS?

Critical Care Medicine ◽

10.1097/00003246-200512002-00176 ◽

2005 ◽

Vol 33 ◽

pp. A48

Author(s):

Katie Burenheide ◽

W Christopher Bandy

Keyword(s):

Bleeding Complications ◽

Trauma Patients ◽

Thromboembolic Events ◽

Thromboembolic Prophylaxis ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic

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Recurrence of Upper Extremity Deep Vein Thrombosis Secondary to COVID-19

Viruses ◽

10.3390/v13050878 ◽

2021 ◽

Vol 13 (5) ◽

pp. 878

Author(s):

Yesha H. Parekh ◽

Nicole J. Altomare ◽

Erin P. McDonnell ◽

Martin J. Blaser ◽

Payal D. Parikh

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Upper Extremity ◽

Thromboembolic Events ◽

Vein Thrombosis ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Deep Vein

Infection with SARS-CoV-2 leading to COVID-19 induces hyperinflammatory and hypercoagulable states, resulting in arterial and venous thromboembolic events. Deep vein thrombosis (DVT) has been well reported in COVID-19 patients. While most DVTs occur in a lower extremity, involvement of the upper extremity is uncommon. In this report, we describe the first reported patient with an upper extremity DVT recurrence secondary to COVID-19 infection.

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