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Deep vein thrombosis in orthopedic surgery.
Clin Appl Thromb Hemost 2009; 15(5):512-6CA

Abstract

We compared 315 patients with deep vein thrombosis who underwent major orthopedic surgery with 618 who underwent general surgery in a prospective registry of consecutive ultrasound-confirmed deep vein thrombosis patients. Orthopedic patients had fewer indwelling central venous catheters (14.0% vs. 46.4%, P < .0001) as well as lower rates of congestive heart failure (7.0% vs. 13.4%, P = .002), cancer (5.1% vs. 28.6%, P < .0001), and diabetes (7.0% vs. 12.6%, P = .004). Extremity discomfort (43.5% vs. 30.3%, P < .0001) and erythema (10.1% vs. 4.8%, P = .001) were more common in orthopedic patients, but dyspnea was less common (11.4% vs. 18.0%, P = .005). There was an increased use of graduated compression stockings (19.4% vs. 15.0%, P = .04), low-molecular-weight heparin (18.7% vs. 12.1%, P = .003), and warfarin (31.7% vs. 11.0%, P < .0001) for deep vein thrombosis prophylaxis in the orthopedic surgery group. Orthopedic surgical patients had a higher frequency of calf deep vein thrombosis than patients who underwent general surgery (38.4% vs. 2.1%, P < .0001). In both groups, 28% did not receive prophylaxis. In conclusion, despite having fewer comorbid conditions, orthopedic patients with deep vein thrombosis remain particularly vulnerable to calf deep vein thrombosis. Rates of venous thromboembolism prophylaxis were inadequate.

Authors+Show Affiliations

Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts, USA. mcalfon@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19491122

Citation

Calfon, Marcella, et al. "Deep Vein Thrombosis in Orthopedic Surgery." Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, vol. 15, no. 5, 2009, pp. 512-6.
Calfon M, Seddighzadeh A, Piazza G, et al. Deep vein thrombosis in orthopedic surgery. Clin Appl Thromb Hemost. 2009;15(5):512-6.
Calfon, M., Seddighzadeh, A., Piazza, G., & Goldhaber, S. Z. (2009). Deep vein thrombosis in orthopedic surgery. Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 15(5), pp. 512-6. doi:10.1177/1076029608330471.
Calfon M, et al. Deep Vein Thrombosis in Orthopedic Surgery. Clin Appl Thromb Hemost. 2009;15(5):512-6. PubMed PMID: 19491122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep vein thrombosis in orthopedic surgery. AU - Calfon,Marcella, AU - Seddighzadeh,Ali, AU - Piazza,Gregory, AU - Goldhaber,Samuel Z, Y1 - 2009/06/01/ PY - 2009/6/4/entrez PY - 2009/6/6/pubmed PY - 2010/3/10/medline SP - 512 EP - 6 JF - Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis JO - Clin. Appl. Thromb. Hemost. VL - 15 IS - 5 N2 - We compared 315 patients with deep vein thrombosis who underwent major orthopedic surgery with 618 who underwent general surgery in a prospective registry of consecutive ultrasound-confirmed deep vein thrombosis patients. Orthopedic patients had fewer indwelling central venous catheters (14.0% vs. 46.4%, P < .0001) as well as lower rates of congestive heart failure (7.0% vs. 13.4%, P = .002), cancer (5.1% vs. 28.6%, P < .0001), and diabetes (7.0% vs. 12.6%, P = .004). Extremity discomfort (43.5% vs. 30.3%, P < .0001) and erythema (10.1% vs. 4.8%, P = .001) were more common in orthopedic patients, but dyspnea was less common (11.4% vs. 18.0%, P = .005). There was an increased use of graduated compression stockings (19.4% vs. 15.0%, P = .04), low-molecular-weight heparin (18.7% vs. 12.1%, P = .003), and warfarin (31.7% vs. 11.0%, P < .0001) for deep vein thrombosis prophylaxis in the orthopedic surgery group. Orthopedic surgical patients had a higher frequency of calf deep vein thrombosis than patients who underwent general surgery (38.4% vs. 2.1%, P < .0001). In both groups, 28% did not receive prophylaxis. In conclusion, despite having fewer comorbid conditions, orthopedic patients with deep vein thrombosis remain particularly vulnerable to calf deep vein thrombosis. Rates of venous thromboembolism prophylaxis were inadequate. SN - 1938-2723 UR - https://www.unboundmedicine.com/medline/citation/19491122/Deep_vein_thrombosis_in_orthopedic_surgery_ L2 - http://journals.sagepub.com/doi/full/10.1177/1076029608330471?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -