scholarly journals Postoperative Aspirin Use and Its Effect on Bone Healing in the Treatment of Ankle Fractures

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Allison Hunter ◽  
Charles Pitts ◽  
Tyler Montgomery ◽  
Matthew Anderson ◽  
John T. Wilson ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Delayed Union ◽  
Ankle Fractures ◽  
P Value ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Ankle Trauma ◽  
Operative Fixation ◽  
Deep Vein ◽  
Radiographic Union

Category: Ankle, Trauma Introduction/Purpose: There is hesitancy to administer nonsteroidal anti-inflammatories (NSAIDs) within the postoperative period following fracture care due to concern for delayed union or nonunion. However, aspirin (ASA) is routinely used for chemoprophylaxis of deep vein thrombosis (DVT) and is gaining popularity for use after treatment of ankle fractures. We examine the incidence of nonunion of operative ankle fractures and risk of DVT in patients who did and did not receive postoperative ASA. We hypothesize that time to clinical and radiographic union and the risk of DVT are no different. Methods: A retrospective chart review was performed on all patients treated between 2008 and 2018 for ankle fractures requiring operative fixation by three Foot and Ankle fellowship trained orthopaedic surgeons at a single institution with a minimum of 3 months follow up. Demographics, preoperative comorbidities, and postoperative medical and surgical complications were compared between patients who did and did not receive ASA postoperatively. For both groups, union was evaluated by clinical exam as well as by radiograph. Results: 506 patients met inclusion criteria: 152 received ASA and 354 did not. Radiographic healing at 6 weeks was demonstrated in 95.9% (94/98) and 98.6% (207/210) respectively (p-value .2134). There was no significant difference in time to radiographic union between groups. The risk of postoperative DVTs in those with and without ASA was not significantly different (0.7% (1/137) vs 1.2% (4/323), respectively; p-value .6305). Conclusion: Postoperative use of ASA does not delay radiographic union of operative ankle fractures or affect the rate of postoperative DVT. This is the first and largest study to examine the effect of ASA on time to union of ankle fractures.

An Enzyme Immunoassay (ELISA) for the Quantitation of Human Factor VII

1986 ◽  
Vol 56 (03) ◽  
pp. 250-255 ◽  
Author(s):  
C Boyer ◽  
M Wolf ◽  
C Rothschild ◽  
M Migaud ◽  
J Amiral ◽  
...  
Keyword(s):  
Human Factor ◽  
Solid Phase ◽  
Factor Vii ◽  
Enzyme Linked Immunosorbent Assay ◽  
Poor Correlation ◽  
Vein Thrombosis ◽  
Coagulant Activity ◽  
Significant Difference ◽  
Large Populations ◽  
Deep Vein

SummaryA new solid phase enzyme-linked immunosorbent assay (ELISA) was developed for the quantitation of human Factor VII antigen (F VII Ag), using a monospecific rabbit anti-F VII antiserum. Anti-F VII F(ab′)2 fragments were adsorbed to polystyrene plates. The binding of serial dilutions of control or test plasma, containing F VII, was detected by incubation with peroxidase-labeled anti- FV II IgG followed by the addition of hydrogen peroxyde and O-phenylenediamine. This ELISA is specific, sensitive (detection limit: 0.05%) and accurate (coefficient of variation: 1.5-4% for within- and 1.6-9% for between-assays). F VII coagulant activity (F VII C) and F VII Ag were determined in large populations of controls and patients. In normal plasma (n = 38), F VII Ag ranged from 83 to 117% and the correlation coefficient between F VII Ag and F VII C was 0.94. In patients with severe (F VII C inf. 1%) congenital F VII deficiency (n = 5), F VII Ag was undetectable in two cases (inf. 0.05%) and markedly reduced (0.35 to 5.6%) in the three other cases. In patients with liver cirrhosis (n = 15), F VII Ag ranged from 21 to 59% and was in good correlation with F VII C (r = 0.84). In dicoumarol treated patients (n = 15), the levels of F VII Ag ranged from 51% to 79% and a poor correlation (r = 0.52) with F VIIC was observed. In “compensated” DIC (n = 5), levels of F VII Ag varied from 60 to 186%, with significantly higher F VII C levels (from 143 to 189%). In contrast, in “decompensated” DIC (n = 7), low F VII Ag and F VII C levels were observed (from 7 to 27%). In patients with deep-vein thrombosis (n = 25), high levels of F VII Ag (from 102 to 136%) and F VII C (from 110 to 150%) were demonstrated. In surgical patients, no significant difference was observed before and one day after intervention.

P6461The long-term clinical comparisons of symptomatic patients of pulmonary embolism with and those without deep vein thrombosis: from the COMMAND VTE Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Murata ◽  
Y Yamashita ◽  
T Morimoto ◽  
H Amano ◽  
T Takase ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Acute Phase ◽  
Clinical Presentation ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Severe Clinical Presentation ◽  
Recurrent Vte ◽  
Deep Vein

Abstract Background Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), has significant morbidity and mortality. Acute PE, in particular, is fatal if we miss it, and symptomatic patients of PE sometimes have concomitant DVT. Purpose This study compared the risk of mortality in symptomatic patients of PE with and those without DVT in the long term. Methods The COMMAND VTE Registry is a multicenter registry enrolling consecutive 3027 patients with acute symptomatic VTE objectively confirmed by imaging examination or by autopsy among 29 centers in Japan between January 2010 and August 2014. Patients with both PE and DVT (N=1334) were regarded as PE patients, and the current study population consisted of 1715 PE patients and 1312 DVT patients. Results There were 1203 symptomatic patients of PE, including 381 without and 822 with DVT. In our cohort, the mean age was 67.9±14.9 years, 63% was female, 44% had hypertension, 12% diabetes mellitus, 5% history of VTE. There were 20% of active cancer. Baseline characteristics were well matched except for dyslipidemia (18% vs. 23%, p=0.021) and atrial fibrillation (8% vs. 5%, p=0.045). Patients without DVT had a more severe clinical presentation compared to those with DVT, including hypoxemia, shock and arrest. Moreover, Initial parenteral anticoagulation therapy in the acute phase was administered less frequently in patients without DVT (89% vs. 96%, P=0.0001). Two groups received thrombolysis (20% vs. 26%, P=0.18) and mechanical supports (Ventilator 14% vs. 5%, p<0.001, PCPS 5% vs. 3%, p<0.001, respectively). During follow-up, 93 (8%) patients experienced recurrent VTE events and 98 (8%) major bleeding events, and 323 (27%) patients died. The most frequent cause of death was cancer (11%). There were a significant differences in the cumulative incidences of all-cause death between the groups (32% vs. 24%, P=0.006), whereas there was significant difference in VTE-related death (13% vs. 4%, p<0.001). Estimated freedom rates from death for patients of PE without and those with DVT were as follows: 88% vs 99% at 10-day, 86% vs 95% at 1-month, 75% vs 83% at 1-year, and 64% vs 71% at 5-year, respectively. Landmark analysis Conclusions In symptomatic patients of PE, there was a difference in mortality between groups, but no difference in recurrent VTE. Patients without DVT had a more severe clinical presentation compared to those with DVT, and many VTE-related deaths in the acute phase. The one-month mortality rate differed statistically between groups, but there was no significant difference in long-term survival beyond one month. Most of deaths were due to underlying diseases, mainly cancer, and less commonly due to VTE in the long term. Acknowledgement/Funding Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation

Comparative Study of Deep Vein Thrombosis Recanalization Using Doppler Ultrasound in Different Post-Treatment Intervals in Traumatic Patients

2022 ◽  
Author(s):  
Nazanin Farshchian ◽  
Negin Farshchian ◽  
Parisa Bahrami Kamangar
Keyword(s):  
Deep Vein Thrombosis ◽  
Doppler Ultrasound ◽  
Statistical Tests ◽  
Significance Level ◽  
Sonographic Diagnosis ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
High Incidence ◽  
Deep Vein ◽  
Comparative Examination

Deep vein thrombosis (DVT) is a prevalent vascular disease characterized by pelvic and limb deep vein thrombophlebitis, and it has a high incidence in traumatic patients. Contrary to older studies, recent research has reported that recanalization in DVT is not a slow process. The present study aimed at the comparative examination of DVT recanalization with Doppler ultrasound in different intervals following treatment with heparin or enoxaparin. This prospective study was conducted on all traumatic patients hospitalized in Imam Reza Hospital of Kermanshah, Iran, with the clinical and sonographic diagnosis of DVT in limb veins. Doppler ultrasound was performed two weeks, one month, and three months following treatment in order to examine recanalization. Data were analyzed using statistical tests in SPSS16 at the significance level of <0.05. Based on Doppler ultrasound, a significant difference was found between the degree of recanalization in patients aged <45 years and those aged >45 years, between male and female patients, and between different DVT locations (P<0.05). After three months of treatment with heparin and enoxaparin, the degree of recanalization was increased in DVT. Moreover, it was found that Doppler ultrasound is a useful tool for the diagnosis of recanalization in patients with DVT.

scholarly journals Impact of IVC Filter Guidelines, Registry, and Clinic on Filter Retrieval.

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Brandon Kiley, BS ◽  
Lisa Hollister, MSN, RN ◽  
T. Eric White, MD ◽  
Emily Keltner, BS, MA ◽  
Thein Zhu, MBBS, FACE, FRCP ◽  
...  
Keyword(s):  
Complication Rate ◽  
Dwell Time ◽  
Filter Placement ◽  
Vein Thrombosis ◽  
Retrieval Rate ◽  
Filter Retrieval ◽  
Significant Difference ◽  
Before And After ◽  
Deep Vein

Background and hypothesis: Deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively referred to as venous thromboembolism (VTE), are serious medical conditions that affect up to 900,000 Americans yearly, accounting for up to 100,000 deaths. The first line treatment for VTE is anticoagulation; however, in patients who experience a contraindication to, or failure of anticoagulation, an IVCF may be used. There are two types of IVCFs, permanent and retrievable. Retrievable filters are indicated when the contraindication to anticoagulation is transient, and they may be removed once the contraindication has passed. Retrievable filters have become associated with serious complications such as filter fracture, migration, and IVC perforation. Subsequently, they have become the subject of litigation. As such, strategies should be undertaken to reduce filter dwell time and improve filter retrieval rates. We hypothesize that implementation of IVCF guidelines, registry, and clinic will reduce dwell time while increasing retrieval rate. Methods: This study was a mixed retrospective and prospective chart review of patients who received an IVCF before and after implementation of IVCF guidelines, registry, and clinic. The guidelines, registry, and clinic were established in July 2017. Cases were analyzed during the years 2014-2015 (n=191) and 2017-2018 (n=103) beginning in July 2017. Data was obtained on filter retrieval rate, dwell time, filter-associated complications, and indication for placement. Results: There was a significant decrease in dwell time (p<.001) and a significant increase in retrieval rate (p<.001). There was no difference in complication rate, and there was a decrease in filter placement in patients with ‘soft’ indications, though this difference was not statistically significant (p=.109). Conclusion and potential impact: Implementation of dedicated efforts to increase patient follow-up and filter retrieval were effective in reducing dwell time and retrieval rate. Although there was no significant difference in complication rate, these efforts may be protective against litigation for patients who experience a filter-associated complication.

scholarly journals Incidence of clinically suspected venous thromboembolism in British Indian patients

2018 ◽  
Vol 100 (5) ◽  
pp. 413-416 ◽  
Author(s):  
BM Siddiqui ◽  
MS Patel ◽  
S Rudge ◽  
A Best ◽  
J Mangwani
Keyword(s):  
Public Health ◽  
Venous Thromboembolism ◽  
Public Health Issue ◽  
Major Public Health Issue ◽  
Vein Thrombosis ◽  
Indian Patients ◽  
Significant Difference ◽  
The World ◽  
The Uk ◽  
Deep Vein

Introduction Venous thromboembolism (VTE) remains a major public health issue around the world. Ethnicity is known to alter the incidence of VTE. To our knowledge, there are no reports in the literature investigating the incidence of VTE in British Indians. The aim of this study was to investigate the rates of symptomatic VTE in British Indian patients in the UK. Methods Patients referred to our institution between January 2011 and August 2013 with clinically suspected VTE were eligible for inclusion in the study. Those not of British Indian or Caucasian ethnicity were excluded. A retrospective review of these two cohorts was conducted. Results Overall, 15,529 cases were referred to our institution for suspected VTE. This included 1,498 individuals of British Indian ethnicity. Of these, 182 (12%) had confirmed VTE episodes. A further 13,159 of the patients with suspected VTE were coded as Caucasian, including 2,412 (16%) who had confirmed VTE events. VTE rates were a third lower in British Indians with clinically suspected VTE than in the equivalent Caucasian group. The British Indian cohort presented with VTE at a much earlier age than Caucasians (mean 57.0 vs 68.0 years). Conclusions This study suggests that British Indian patients have a lower incidence of VTE and are more likely to present at an earlier age than Caucasians. There was no significant difference in VTE type (deep vein thrombosis vs pulmonary embolism) among the ethnic groups. Clinicians should be aware of variations within ethnicities but should continue to adhere to existing VTE prevention guidance.

scholarly journals Postoperative Increase of Heparin in Prevention of Deep Vein Thrombosis (DVT) After Total hip Replacement

1977 ◽  
Author(s):  
T.H. Schöndorf ◽  
D. Hey
Keyword(s):  
Hip Replacement ◽  
Vein Thrombosis ◽  
Group I ◽  
Total Incidence ◽  
Significant Difference ◽  
Risk Patients ◽  
Positive Scan ◽  
Fibrinogen Test ◽  
Deep Vein ◽  
Heparin Prophylaxis

Acetylsalicylic-lysine (ASL) and a modified low dose heparin prophylaxis were examined to prevent postoperative DVT. 71 patients over 40 years undergoing hip replacement were randomised according to odd or even year of birth. Group I: 1.8g ASL were injected i.v. after the operation and then 24 hourly for 9 days. Group II: 5 000 IE heparin were given s.c. 10 and 2 hours before operation and continued in 8 hour-intervals until the evening of the first postoperative day. Heparin was subsequently increased to 3 × 7 500 IE/24 hours. DVT was diagnosed by the 125-I-fibrinogen test; in all legs with a positive scan a venography was performed. Partial-thromboplastin time and platelet aggregation was regularily controlled.The total incidence of DVT under the heparin prophylaxis (4/58) was significantly less than under the ASL-treatment (19/33); the rate of popliteal-femoral DVT revealed a similar significant difference. DVT opposite to the operated hip and bilateral DVT developed only under the ASL-treatment. The postoperative haematocrit decrease and the amount of blood from the wound drainage of the two groups did not differ statistically. Major wound bleeding occurred under ASL in one and in two patients under heparin.ASL did not prevent DVT sufficiently, but DVT was effectively reduced by the postoperative increase of heparin in these high risk patients.

Optimization of ascending phlebography of the leg for screening of deep vein thrombosis in thromboprophylactic trials

1997 ◽  
Vol 38 (2) ◽  
pp. 320-326 ◽  
Author(s):  
P. Kälebo ◽  
B.-A. Anthmyr ◽  
B. I. Eriksson ◽  
B. E. Zachrisson
Keyword(s):  
Deep Vein Thrombosis ◽  
Screening Method ◽  
Clinical Suspicion ◽  
Vein Thrombosis ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Venous Filling ◽  
Anterior Tibial ◽  
Deep Vein ◽  
Better Than

Purpose: Comparison of 2 phlebographic techniques in achieving adequacy of deep venous filling. Material and Methods: Sixty consecutive patients with a clinical suspicion of deep vein thrombosis (DVT) were examined by 2 different techniques, A according to GREITZ and B according to LEA THOMAS. All deep veins were scored according to a protocol as DVT, normal or inadequate. Venous evaluability and DVT rates were compared. Bilateral phlebograms according to the A-technique from 92 asymptomatic patients in a different trial were reviewed to allow comparison with the symptomatic subjects. Results: the A-technique resulted in a significantly higher degree of overall evalu-able patients compared to the B-technique, 95% vs 47%. A vein-by-vein analysis showed that the A-technique was significantly better than the B-technique in filling the gastrocnemius muscular (82% vs 38%), anterior tibial (85% vs 43%), and deep femoral (28% vs 18%) veins. No significant difference was found in the other veins. the DVT rates were 42% and 40% respectively for the A- and B-techniques. About 94% of the phlebograms in the asymptomatic patients were adequate. Conclusion: the A-technique resulted in better venous opacification and would seem to be a more suitable screening method for asymptomatic persons.

scholarly journals The use of prophylaxis in patients undergoing diagnostic tests for suspected venous thromboembolism

2010 ◽  
Vol 25 (2) ◽  
pp. 85-93
Author(s):  
J-A Lee ◽  
B K Zierler
Keyword(s):  
Venous Thromboembolism ◽  
Medical Records ◽  
Diagnostic Tests ◽  
P Value ◽  
Academic Medical Centre ◽  
Pharmacological Prophylaxis ◽  
Mechanical Prophylaxis ◽  
Vein Thrombosis ◽  
Academic Medical ◽  
Deep Vein

Objectives The purpose of this study was to describe the use of pharmacological and mechanical prophylaxis and clinical outcomes of patients undergoing diagnostic tests for suspected venous thromboembolism (VTE). Methods The medical records of 660 consecutive inpatients referred for suspected VTE at an academic medical centre were retrospectively reviewed. Results Acute VTE was diagnosed in 138 (21%) of the 660 patients; the incidence of deep vein thrombosis and pulmonary embolism was 18–25%, respectively. Only 61% of eligible patients received pharmacological prophylaxis and 43% of patients received mechanical prophylaxis. The incidence of VTE was higher in patients who did not receive pharmacological prophylaxis (30%) compared with patients who did (16%, P value <0.001). Conclusions Preventive measures for VTE, including both pharmacological and mechanical prophylaxis, were underutilized in hospitalized patients undergoing diagnostic tests for suspected VTE.

scholarly journals Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Dongquan Shi ◽  
Xingquan Xu ◽  
Kai Song ◽  
Zhihong Xu ◽  
Jin Dai ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Osteoarthritis ◽  
Total Hip ◽  
Related Data ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Deep Vein

Objective.Ankylosing spondylitis (AS), an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients’ quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT) between AS and hip osteoarthritis.Methods.In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups.Results.The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P=0.89). The patients of AS group were much younger (P<0.0001) and thinner (P=0.018) compared with those of OA group. AS patients had higher ejection fraction (EF) (P=0.016), higher platelet counts (P<0.0001), and lower hypertension rate (P=0.0004). The values of APTT, PT, and INR in AS patients were higher than those in OA patients (allP<0.0001). The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects.Conclusion.AS patients potentially had a lower incidence of DVT compared with OA patients.

scholarly journals Deep Vein Thrombosis, Demographic Characteristics and Risk Factors in Iran

2013 ◽  
Vol 2 (4) ◽  
pp. 135-140
Author(s):  
Shokoufeh Hajsadeghi ◽  
Scott Reza Jafarian Kerman ◽  
Rashin Joodat ◽  
Maral Hejratie ◽  
Helen Vaferi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Deep Vein Thrombosis ◽  
Health Care Systems ◽  
Care Providers ◽  
Female Ratio ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Care Systems ◽  
Deep Vein

Background: Deep vein thrombosis (DVT) can be an ethnicity related disease and an important health issue for health-care systems. Thus, domestic recognition of risk factors and disease characteristics seem to be inevitable. This study was designed to evaluate the epidemiology, basic characteristics, and risk factors in patients with DVT.Materials and Methods: In this descriptive cross-sectional study, all patients with primary or final diagnosis of DVT, confirmed by Doppler ultrasound in a 5-year period were included. Demographic data and prognosis were extracted from medical files. To evaluate the outcome of the patients after discharge, a phone-call follow-up was performed for all available patients.Results: Three-hundred seventy-one DVT patients were included with 232/139 male to female ratio. The mean age was 55.72±20.01 years with significant difference between genders (p=0.006). Mean weight was 88.97±10.2 kg with no significant difference between genders (p=0.74). The most common affected veins were common femoral vein (257 cases, 69.2%), followed by Popliteal, iliac, axillary, and subclavian veins. No season preference was seen in DVT occurrence. One-year survival of the patients after discharge was 92.6% and two-year survival was 87.7%.Conclusion: By knowing local information about this disease, health-care providers can give accurate warnings and suggestions to prevent the probable thrombosis chances. As Iran lacked information about DVT characteristics, this study can be an epidemiologic guide for health-care systems and an opening path for future studies.

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