Venous Thromboembolism
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Orthopedics ◽  
2021 ◽  
pp. 1-7
Elbert J. Mets ◽  
Neil Pathak ◽  
Anoop R. Galivanche ◽  
Ryan P. McLynn ◽  
David B. Frumberg ◽  

2021 ◽  
pp. 104-111
Yasser Alotaibi ◽  
Maha Bassim ◽  
Noura Alnowaiser ◽  
Mohamed Nassif ◽  
Amal Al-Gosi ◽  

2021 ◽  
Vol 10 (23) ◽  
pp. 5673
Irit Ayalon-Dangur ◽  
Yakov Vega ◽  
Miriam Rozi Israel ◽  
Alon Grossman ◽  
Galia Spectre ◽  

Introduction: Randomized controlled trials that compared direct oral anticoagulants (DOACs) to vitamin K antagonists (VKA) for the treatment of venous thromboembolism (VTE), demonstrated both efficacy and safety of DOACs. The aim of the current study was to compare DOACs to VKA for the treatment of VTE in the elderly, in a real-life setting. Methods: A retrospective cohort study was performed in Rabin Medical Center encompassing a 7-year period. Hospitalized patients >65 years, with a diagnosis of VTE discharged with DOACs or VKA were included. The primary outcome was a composite of all-cause mortality, major bleeding, recurrent VTEs and hospitalizations throughout the follow-up period of one year. Results: A total of 603 patients were included in the final analysis. The mean age was 79.6 ± 8.5 years. The primary composite outcome occurred in 74.6% and 56.7% of the patients in the VKA group and DOACs group, respectively, hazard ratio 0.59, 95% confidence interval 0.46 to 0.76, in favor of the DOACs group. In a matched cohort analysis, the results were the same as the original analysis. Conclusion: In the elderly population, treatment of VTE with DOACs was associated with a lower rate of the composite outcome. DOACs are safe and effective for elderly patients with VTE.

Tai-Li Chen ◽  
Ling-Ling Lee ◽  
Huei-Kai Huang ◽  
Jen-Hung Wang ◽  
Li-Yu Chen ◽  

2021 ◽  
Vol Publish Ahead of Print ◽  
Nikhil A. Agrawal ◽  
Kirsty Hillier ◽  
Riten Kumar ◽  
Shayan Izaddoost ◽  
Rod J. Rohrich

Ryohei Ono ◽  
Kenichi Fukushima ◽  
Tatsuro Yamazaki ◽  
Daichi Yamashita ◽  
Hidehisa Takahashi ◽  

2021 ◽  
Kenta Hayashida ◽  
Yusuke Kawabata ◽  
Keiju Saito ◽  
Shintaro Fujita ◽  
Hyonmin Choe ◽  

Abstract Background: Venous thromboembolism (VTE) is a major complication in patients with malignant tumors and orthopedic disorders. Although it is known that patients undergoing surgery for orthopedic oncology are at an increased risk of thromboembolic events, only few studies have investigated this risk in detail. Therefore, the aim of this study was to determine the incidence and risk factors for preoperative VTE in orthopedic oncology patients.Methods: We retrospectively reviewed the medical records of 270 patients who underwent surgical procedures, including biopsy for orthopedic oncology, have undergone measurements of preoperative D-dimer levels, and were subsequently screened for VTE by lower extremity venous ultrasonography and/or contrast-enhanced computed tomography scans. Statistical analyses were performed to examine the incidence and risk factors for VTE. Receiver operating characteristic (ROC) analysis was performed to verify the D-dimer cutoff value for the diagnosis of VTE.Results: Overall, 199 patients (103 with primary soft tissue sarcomas, 38 with primary bone sarcomas, 46 with metastatic tumors, and 12 with hematologic malignancies) were included. D-dimer levels were high in 79 patients; VTE was detected in 19 patients (9.5%). Multivariate analysis indicated that age ≥60 years (P = 0.021) and tumor location in the lower limbs (P = 0.048) were independent risk factors for VTE. ROC analysis showed that the D-dimer cutoff value for the diagnosis of VTE was 1.53 µg/mL; the sensitivity and specificity were 89.5% and 79.4%, respectively.Conclusions: Our study indicated that age and tumor location in the lower limbs were independent risk factors for preoperative VTE in orthopedic oncology patients. D-dimer levels were not associated with VTE in the multivariate analysis, likely because they are affected by a wide variety of conditions, such as malignancy and aging. Patients with high D-dimer levels and the identified risk factors are at an increased risk of preoperative VTE, and additional ultrasonography should be considered.Trial registration: Our study was approved by the institutional review board. The registration number is B200600056. The registration date was July 13, 2020.

J. R. Gonzalez-Porras ◽  
J. Mateo ◽  
V. Gonzalez-Calle ◽  
P. Marco ◽  
V. Garcia-Gutierrez ◽  

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