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Analysis examines rate of in-hospital blood clots following hip, knee replacement

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A recently published review found that approximately 1 in every 200 patients undergoing hip replacement will develop a venous thromboembolism before hospital discharge when current venous thromboembolism preventive medications are used.

The findings were recently published in the Journal of the American Medical Association and also revealed that 1 in every 100 patients undergoing knee replacement will develop a venous thromboembolism (VTE).

“These estimates are of value to individuals and organizations seeking to evaluate institutional VTE event rates against contemporary benchmarks,” Jean-Marie Januel, RN, MPH, and colleagues wrote in their review. “Our above-mentioned rate estimates provide these contemporary benchmarks.”

The review set out to establish a contemporary, literature-based estimate of symptomatic VTE rates prior to hospital discharge in patients undergoing total or partial hip arthroplasty and total or partial knee arthroplasty who received recommended VTE prophylaxis during their hospitalization. The researchers conducted a search of the existing medical literature to identify 47 relevant studies that met inclusion criteria. Six of these studies were observational and 41 were randomized clinical trials.

Twenty-one of the studies included patients undergoing hip arthroplasty, 20 included patients undergoing knee arthroplasty and six included both hip and knee patients. Overall, the review included 44,844 patients. Of these, 21,369 had total or partial hip arthroplasties and 23,475 had total or partial knee arthroplasties.

In the patients undergoing hip arthroplasty, the investigators found pooled incidence rates of 0.53% for symptomatic postoperative VTE; 0.26% for deep vein thrombosis (DVT) and 0.14% for pulmonary embolism.

For patients undergoing TPKA, the rates were 1.09%, 0.63% and 0.27%, respectively.

Reference:

• www.pubs.ama-assn.org
• Januel JM, Chen G, Ruffieux C, et al. Symptomatic in-hospital deep vein thrombosis and pulmonary embolism following hip and knee arthroplasty among patients receiving recommended prophylaxis. J Am Med Assoc. 2011. doi: 10.1001/jama.2011.2029.

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