November 19, 2018Thrombosis and Haemostasis
Safety of In-Hospital Only Thromboprophylaxis after Fast-Track Total Hip and Knee Arthroplasty: A Prospective Follow-Up Study in 17,582 Procedures
Key result
The 90-day incidence of symptomatic VTE after fast-track total hip and knee arthroplasty with in-hospital thromboprophylaxis only was 0.40%.
Why the study?
Guidelines recommend thromboprophylaxis for 10 to 35 days after THA/TKA, but fast-track surgery questioned the need for prolonged prophylaxis when length of stay is 5 days or less.
What is the incidence of symptomatic VTE in patients undergoing fast-track THA/TKA receiving only in-hospital thromboprophylaxis?
Population
17,582 elective unilateral THA or TKA procedures with length of stay 5 days or less
Comparison
In-hospital only thromboprophylaxis
Design
Prospective cohort study
Follow-up
90-day
Authors
Discussion
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Member takes
Implication
May support shorter thromboprophylaxis in fast-track THA/TKA; leaves open confirmation in randomized trials.
Study Design
Type
Cohort (n=17,582)
Structured PICO
What is the incidence of symptomatic VTE in patients undergoing fast-track THA/TKA receiving only in-hospital thromboprophylaxis?
P
Population
17,582 patients undergoing elective unilateral fast-track total hip and knee arthroplasty with length of stay ≤ 5 days, excluding those on pre-operative anticoagulants, followed for 90 days.
E
Exposure
In-hospital only pharmacological thromboprophylaxis
O
Outcome
Incidence of symptomatic venous thromboembolism (VTE) at 90-day follow-uphard clinical
In-hospital only thromboprophylaxis after fast-track THA/TKA with a length of stay ≤ 5 days is associated with a low 90-day incidence of symptomatic VTE (0.40%), challenging guidelines that recommend prolonged prophylaxis.
Cite This Study
Petersen et al. (2018) conducted a cohort in Total hip and knee arthroplasty (THA/TKA) (n=17,582). In-hospital only thromboprophylaxis was evaluated on Symptomatic venous thromboembolism (VTE). The 90-day incidence of symptomatic VTE after fast-track total hip and knee arthroplasty with in-hospital thromboprophylaxis only was 0.40%.