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September 15, 1997Annals of Internal Medicine

Ultrasonographic Screening before Hospital Discharge for Deep Venous Thrombosis after Arthroplasty: The Post-Arthroplasty Screening Study: A Randomized, Controlled Trial

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Why the study?

Does screening compression ultrasonography before hospital discharge reduce symptomatic deep venous thrombosis or pulmonary embolism in patients undergoing elective total hip or knee arthroplasty receiving warfarin prophylaxis?

Population

1024 patients undergoing elective total hip or knee arthroplasty who received warfarin prophylaxis.

Comparison

Bilateral compression ultrasonography before… vs Sham procedure before hospital discharge, with…

Design

RCT, randomly assigned, Double-blind

Follow-up

90 days

Authors

KRKatherine RobinsonDalhousie University

Discussion

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Implication

Screening ultrasonography adds no benefit over warfarin alone after joint arthroplasty; challenges routine pre-discharge imaging in this population.

Structured PICO

Does screening compression ultrasonography before hospital discharge reduce symptomatic deep venous thrombosis or pulmonary embolism in patients undergoing elective total hip or knee arthroplasty receiving warfarin prophylaxis?

P
Population
1024 patients undergoing elective total hip or knee arthroplasty who received warfarin prophylaxis.
I
Intervention
Bilateral compression ultrasonography before hospital discharge. Patients diagnosed with asymptomatic deep venous thrombosis were treated with standard anticoagulant therapy after discharge; otherwise, warfarin therapy was discontinued.
C
Comparator
Sham procedure before hospital discharge, with warfarin therapy discontinued at discharge.
O
Outcome
Total outcome event rate (symptomatic proximal deep venous thrombosis, pulmonary embolism, or major bleeding) at 90 days.hard clinical

Routine screening compression ultrasonography before hospital discharge does not reduce symptomatic venous thromboembolism events in patients undergoing elective joint arthroplasty who received in-hospital warfarin prophylaxis.

Cite This Study

Katherine Robinson (1997) studied this question.

synapsesocial.com/papers/6a7d293f7786afdcaca00326https://doi.org/10.7326/0003-4819-127-6-199709150-00004

Topics

Pulmonary embolismAnticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Venous Thromboembolic Disease After Hybrid Hip Arthroplasty With Negative Duplex Screening1999 · 16 citations
  2. 2Incidence of Posthospitalization Proximal Deep Venous Thrombosis After Total Hip Arthroplasty A Pilot Study1994 · 67 citations
  3. 3Natural History of Thromboembolic Disease After Total Hip Arthroplasty1996 · 89 citations
  4. 4THE JOHN CHARNLEY AWARD: Prevention of Readmission for Venous Thromboembolic Disease after Total Hip Arthroplasty2005 · 59 citations
  5. 5DVT Prophylaxis: Better Living Through Chemistry: Affirms2010 · 4 citations