scholarly journals Up-to-date thromboprophylaxis in elective spinal surgery. A systematic review

2014 ◽  
Vol 13 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Leonardo Oliveira ◽  
Luis Marchi ◽  
Luiz Pimenta
Keyword(s):  
Systematic Review ◽  
Orthopedic Surgery ◽  
Spinal Surgery ◽  
Thrombotic Complication ◽  
Surgical Practice ◽  
Vein Thrombosis ◽  
Legal Problems ◽  
Prophylactic Measures ◽  
High Incidence ◽  
Deep Vein

Deep vein thrombosis (DVT) and pulmonary embolism (PE) present a high incidence after surgery, posing a high risk in surgical practice. Although a consensus does exist on thromboprophylaxis in orthopedic surgery, this topic remains controversial in regard to spinal surgery. In this current paper, we review and discuss the different forms of prophyilaxis presented in literature, in order to develop guidelines on prophylactic measures in spinal surgery, improving patient´s outcomes and reducing any medical/legal problems that could arise from a thrombotic complication.

scholarly journals Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Kochawan Boonyawat ◽  
Pichika Chantrathammachart ◽  
Pawin Numthavaj ◽  
Nithita Nanthatanti ◽  
Sithakom Phusanti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Grey Literature ◽  
Arterial Thromboembolism ◽  
Vein Thrombosis ◽  
Prophylactic Measures ◽  
Compression Ultrasound ◽  
Screening Protocol ◽  
Deep Vein

Abstract Background Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization. Methods Medline, Embase, Scopus, and grey literature were searched until June 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model. Results A total of 36 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 28% (95% CI, 22–34%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (32% [95% CI, 18–45%] vs. 6% [95% CI, 4–9%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2–5%). In the non-ICU setting, the pooled incidence of VTE was 10% (95% CI, 6–14%,). Conclusions The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19.

scholarly journals Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Kochawan Boonyawat ◽  
Pichika Chantrathammachart ◽  
Pawin Numthavej ◽  
Nithita Nanthatanti ◽  
Sithakom Phusanti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Grey Literature ◽  
Arterial Thromboembolism ◽  
Vein Thrombosis ◽  
Prophylactic Measures ◽  
Compression Ultrasound ◽  
Screening Protocol ◽  
Deep Vein

Abstract Background: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization.Methods: Medline, Embase, Scopus, and grey literature were searched until May 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model.Results: A total of 36 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 28% (95% CI, 22-34%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (32% [95% CI, 18-45%] vs. 6% [95% CI, 4-9%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2-5%). In the non-ICU setting, the pooled incidence of VTE was 10% (95% CI, 6-14%,).Conclusions:The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19.

scholarly journals Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Kochawan Boonyawat ◽  
Pichika Chantrathammachart ◽  
Pawin Numthavej ◽  
Nithita Nanthatanti ◽  
Sithakom Phusanti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Grey Literature ◽  
Arterial Thromboembolism ◽  
Vein Thrombosis ◽  
Prophylactic Measures ◽  
Compression Ultrasound ◽  
Screening Protocol ◽  
Deep Vein

Abstract Background Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization. Methods Medline, Embase, Scopus, and grey literature were searched until May 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model. Results A total of 26 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 27% (95% CI, 20–35%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (27% [95% CI, 20–35%] vs. 3% [95% CI, 1–5%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2–4%). In the non-ICU setting, the pooled incidence of VTE was 8% (95% CI, 4–12%,). Conclusions The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19, especially in the ICU setting.

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.

Abnormal Blood Yield Stress as an Aetiological Factor in Postoperative Deep Venous Thrombosis

1975 ◽  
Author(s):  
W. V. Humphreys ◽  
A. Walker ◽  
D. Charlesworth
Keyword(s):  
Deep Vein Thrombosis ◽  
Yield Stress ◽  
Malignant Disease ◽  
Aetiological Factor ◽  
Venous Stasis ◽  
Vein Thrombosis ◽  
High Incidence ◽  
Deep Vein ◽  
Postoperative Deep Venous Thrombosis ◽  
Low Shear

An elevated blood viscosity could lead to increased venous stasis and a higher incidence of post-operative deep vein thrombosis. Immediately preoperatively we have measured, using a Contraves low shear 2 viscometer, blood yield stress and viscosity at high and low shear rate in 28 general surgical patients. These patients were then screened by the standard I125 fibrinogen technique to detect the development of deep vein thrombosis post-operatively.13 patients developed a deep vein thrombosis. These patients had a significantly higher blood yield stress, corrected to a standard haemoerit of 45%, than the others (P < 0.01 students t). All other viscosity parameters were normal in these patients. Patients with malignant disease had a very high incidence of thrombosis (90%: 30%) and significantly higher yield stress values (mean 0.26 dynes/cm2: mean 0.194 dynes/cm2, P < 0.0005 students t) compared to patients with benign disease.We conclude that a high blood yield stress could be an important aetiological factor in thrombosis and the high values obtained in patients with malignant disease could partly explain the high incidence in these patients.

Influence of the Tourniquet on Pain and Function in Total Knee Arthroplasty: a Systematic Review and Meta-Analysis

2019 ◽  
Vol 158 (06) ◽  
pp. 630-640 ◽  
Author(s):  
Ahmed Jawhar ◽  
Dania Skeirek ◽  
Vera Stetzelberger ◽  
Udo Obertacke
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Vein Thrombosis ◽  
Analgesic Consumption ◽  
Total Knee ◽  
Without Tourniquet ◽  
Deep Vein

Abstract Background The use of the tourniquet in total knee arthroplasty is still a subject of controversial discussion. Previous studies mainly focus on parameters like blood loss and operation time. The aim of this systematic review is to evaluate the postoperative outcome involving parameters such as pain intensity, analgesic consumption, knee function and complication rate with and without tourniquet use, to find a recommendation for future application in total knee arthroplasty. Material and Methods This review is based on the PRISMA Checklists. A systematic research was performed in PubMed using the key words “tourniquet”, “total knee arthroplasty”, “TKA” and “knee endoprosthesis” up to and including January 2018. The initial search revealed 686 Papers which were extracted by the parameters intensity of pain, analgesic consumption, function (range of motion, Hospital for Special Surgery Score, Knee Society Score) and complications (deep vein thrombosis, surgical side infection, pulmonary embolism). The program Review Manager Version 5.3 was used for statistical analysis. A significance level of p < 0,05 was defined. Results 18 studies were included in this review with 1279 total knee arthroplasties overall (646 with the use of tourniquet and 633 without). The analysis shows a significant lower pain intensity until the fifth postoperative day (p = 0,03) and also after one to three months (p = 0,04) without using the tourniquet. Range of motion is significantly higher in two to three days postoperatively (p < 0,00 001) when the surgery was performed without tourniquet. Knee Society Score shows no difference between the two groups. A deep vein thrombosis appears significantly more often when using a tourniquet (p = 0,04). There was no higher occurrence in pulmonary embolism and surgical side infections. Conclusion The use of a pneumatic tourniquet in total knee arthroplasty affects especially the early postoperative pain and functional recovery.

Untersuchung zum postoperativen Verlauf bei Patienten mit Hämophilie

2012 ◽  
Vol 32 (S 01) ◽  
pp. S45-S47 ◽  
Author(s):  
S. Krekeler ◽  
S. Alesci ◽  
W. Miesbach
Keyword(s):  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Hip Replacement ◽  
Orthopedic Procedures ◽  
Vein Thrombosis ◽  
Major Orthopedic Surgery ◽  
Lung Embolism ◽  
Total Knee ◽  
Deep Vein ◽  
Observation Period

SummaryThromboembolic complications may occur in patients with major operations even after routine thromboprophylaxis with low-molecularweight-heparin. In this retrospective, single center survey the post-operative course of patients with haemophilia was investigated. Patients, methods Overall, the postoperative course in 85 patients with haemophilia A and B (median age: 43 years, 18–73 years) and 139 surgical procedures was analyzed. The surgical procedures mainly consist of major orthopedic surgery (58 total knee replacement, 15 hip replacement, 17 other major orthopedic surgery, 15 minor orthopedic procedures). Additional surgical procedures were abdominal-surgical (18), urological (8), neurosurgical (5). Results During the post-operative observation period a small number of wound healing complications occurred (4%). None of the patients developed symptomatic deep vein thrombosis or lung embolism. Conclusion There seems to a decreased risk of postoperative thromboembolism in patients with haemophilia.

scholarly journals Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0228788 ◽  
Author(s):  
Noémie Kraaijpoel ◽  
Marc Carrier ◽  
Grégoire Le Gal ◽  
Matthew D. F. McInnes ◽  
Jean-Paul Salameh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Vein Thrombosis ◽  
Deep Vein

Central venous catheters and upper-extremity deep-vein thrombosis complicating immune heparin-induced thrombocytopenia

Blood ◽  
2003 ◽  
Vol 101 (8) ◽  
pp. 3049-3051 ◽  
Author(s):  
Aaron P. Hong ◽  
Deborah J. Cook ◽  
Christopher S. Sigouin ◽  
Theodore E. Warkentin
Keyword(s):  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Orthopedic Surgery ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Heparin Induced Thrombocytopenia ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Limb Deep Vein Thrombosis

Abstract Heparin-induced thrombocytopenia (HIT) is a transient antibody-mediated hypercoagulability state strongly associated with lower-limb deep-vein thrombosis (DVT). Whether HIT is additionally associated with upper-limb DVT—either with or without central venous catheter (CVC) use—is unknown. We therefore studied 260 patients with antibody-positive HIT to determine the influence of CVC use on frequency and localization of upper-extremity DVT in comparison with 2 non-HIT control populations (postoperative orthopedic surgery and intensive-care unit patients). Compared with the control populations, both upper- and lower-extremity DVTs were found to be associated with HIT. Upper-extremity DVTs occurred more frequently in HIT patients with a CVC (14 of 145 [9.7%]) versus none of 115 (0%) patients without a CVC (P = .000 35). All upper-extremity DVTs occurred at the CVC site (right, 12; left, 2; kappa = 1.0; P = .011). We conclude that a localizing vascular injury (CVC use) and a systemic hypercoagulability disorder (HIT) interact to explain upper-extremity DVT complicating HIT.

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