Why the study?
Does routine pharmacological thromboprophylaxis reduce deep vein thrombosis and pulmonary embolism without excessive bleeding risk in patients undergoing total joint arthroplasty in low incidence populations?
Does routine pharmacological thromboprophylaxis reduce deep vein thrombosis and pulmonary embolism without excessive bleeding risk in patients undergoing total joint arthroplasty in low incidence populations?
Routine pharmacological thromboprophylaxis after total joint arthroplasty in low-incidence Asian populations may carry bleeding risks that outweigh the thromboembolic benefits, highlighting the need for individualized risk stratification.
Challenges Western guideline extrapolation in low-DVT East Asian TJA patients; leaves open need for population-specific RCTs before practice change.
Postoperative venous thromboembolism is one of the most serious complications following total joint arthroplasty. Pharmacological and mechanical prophylaxis methods are used to reduce the risk of postoperative symptomatic deep vein thrombosis and pulmonary embolism. Use of pharmacological prophylaxis requires a fine balance between the efficacy of the drug in preventing deep vein thrombosis and the adverse effects associated with the use of these drugs. In regions with a low prevalence of deep vein thrombosis such as Korea, there might be a question whether the benefits of using pharmacological prophylaxis outweigh the risks involved. The current article reviews the need for thromboprophylaxis, guidelines, problems with the guidelines, pharmacological prophylaxis use, and the current scenario of deep vein thrombosis, and discusses whether the use of pharmacological prophylaxis should be mandatory in low incidence populations.
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Kim et al. (2013) studied this question.
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