Mechanical Thromboprophylaxis for Patients Undergoing Hip Fracture Surgery

Mehta, Kinjal; Lee, Haw Chou; Loh, Jiashen

doi:10.1177/230949901001800306

Cited by 10 publications

(7 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 22 24 25) There have been a few reports on preventive effect of IPC in Asians. Sugano et al 14) and Yokote et al 16) reported its effectiveness in Japanese people, Mehta et al 15) in Singapore people, and Jo et al 17) in Korean people.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intermittent Pneumatic Compression for the Prevention of Venous Thromboembolism after Total Hip Arthroplasty

et al. 2017

View full text Add to dashboard Cite

BackgroundVenous thromboembolism (VTE) is a relatively common and potentially life threatening complication after major hip surgery. There are two main types of prophylaxis: chemical and mechanical. Chemical prophylaxis is very effective but causes bleeding complications in surgical wounds and remote organs. On the other hand, mechanical methods are free of hemorrhagic complications but are less effective. We hypothesized that mechanical prophylaxis is effective enough for Asians in whom VTE occurs less frequently. This study evaluated the effect of intermittent pneumatic compression (IPC) in the prevention of VTE after major hip surgery.MethodsIncidences of symptomatic VTE after primary total hip arthroplasty with and without application of IPC were compared. A total of 379 patients were included in the final analysis. The IPC group included 233 patients (106 men and 127 women) with a mean age of 54 years. The control group included 146 patients (80 men and 66 women) with a mean age of 53 years. All patients took low-dose aspirin for 6 weeks after surgery. IPC was applied to both legs just after surgery and maintained all day until discharge. When a symptom or a sign suspicious of VTE, such as swelling or redness of the foot and ankle, Homans' sign, and dyspnea was detected, computed tomography (CT) angiogram or duplex ultrasonogram was performed.ResultsUntil 3 months after surgery, symptomatic VTE occurred in three patients in the IPC group and in 6 patients in the control group. The incidence of VTE was much lower in the IPC group (1.3%) than in the control group (4.1%), but the difference was not statistically significant. Complications associated with the application of IPC were not detected in any patient. Patients affected by VTE were older and hospitalized longer than the unaffected patients.ConclusionsThe results of this study suggest that IPC might be an effective and safe method for the prevention of postoperative VTE.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 13) Therefore, mechanical methods using intermittent pneumatic pumps have been gaining popularity, and variable results on their effectiveness have been reported in Asian countries. 14 15 16 17) …”

mentioning

confidence: 99%

Intermittent Pneumatic Compression for the Prevention of Venous Thromboembolism after Total Hip Arthroplasty

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Elderly patients undergoing HFS are at higher risk of VTE owing to associated immobility along with other risk factors [ 1 , 2 , 17 ]. The immobility due to severe hip pain during the preoperative period may cause venous stasis from the lower extremities, thus increasing the risk of VTE in these patients.…”

Section: Discussionmentioning

confidence: 99%

Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study

et al. 2017

View full text Add to dashboard Cite

BackgroundElderly patients undergoing hip fracture surgery (HFS) are at increased risk of postoperative venous thromboembolism (VTE). To reduce this risk, combined postoperative mechanical and chemical thromboprophylaxis has been routinely performed after HFS in these patients. This retrospective case-control study was conducted to evaluate the additional effectiveness of preoperative mechanical thromboprophylaxis for the prevention of VTE following HFS in elderly patients.MethodsOf 539 consecutive patients aged 70 years or older undergoing HFS, 404 (control group) did not receive preoperative mechanical thromboprophylaxis, while 135 (study group) received mechanical thromboprophylaxis using an intermittent pneumatic compression device and graduated compression stockings from the time of admission until surgery. All patients received combined postoperative mechanical and chemical thromboprophylaxis following HFS in accordance with the same protocol. The incidence of symptomatic VTE confirmed based on clinical symptoms and 3-dimensional CT angiography within one month of surgery was investigated in both groups.ResultsThe American Society of Anesthesiologists grade was higher (p = 0.016) in the study group and more patients in this group had concomitant cardiovascular and neurologic diseases (p = 0.005 and p = 0.009, respectively). In addition, more patients in the study group had received anticoagulant medication preinjury owing to comorbidities (39% vs 28%, p = 0.025). The overall incidences of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) were 7.4% and 3.7%, and 2.2% and 1.5% in the control and study groups, respectively. According to multiple logistic regression, symptomatic DVT significantly reduced in the study group (OR 0.28, p = 0.042), while there was no significant difference in the incidence of symptomatic PE between the two groups (p = 0.223).ConclusionsPreoperative mechanical thromboprophylaxis may confer an additional benefit by preventing postoperative VTE without adding more risk of perioperative bleeding in elderly patients with hip fracture.

show abstract

“…In hip fracture surgery, mechanical VTE prophylactic methods can reduce the incidence of VTE [ 38 ]. In a study by Mehta et al, the authors showed that using an IPCD for ≥20 h per day before and after surgery could reduce VTE in 434 hip fracture patients.…”

Section: Statements Of Group 2: Mechanical Venous Thromboembolism Prophylaxismentioning

confidence: 99%

“…In a study by Mehta et al, the authors showed that using an IPCD for ≥20 h per day before and after surgery could reduce VTE in 434 hip fracture patients. The incidence of DVT was 11 (2.5%) and that of PE was 2 (0.5%) [ 38 ], compared with a previous study, which showed an incidence of DVT of 8% in 104 elderly hip fractures without mechanical thromboprophylaxis [ 39 ]. However, there are inadequate data for fatal PE and mortality rates to make a conclusion.…”

Section: Statements Of Group 2: Mechanical Venous Thromboembolism Prophylaxismentioning

confidence: 99%

Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 2. Mechanical venous thromboembolism prophylaxis

Thiengwittayaporn

Budhiparama

Tanavalee

et al. 2021

Knee Surg & Relat Res

View full text Add to dashboard Cite

Mechanical Thromboprophylaxis for Patients Undergoing Hip Fracture Surgery

Abstract: Routine use of mechanical thromboprophylaxis is recommended in patients undergoing hip fracture surgery.

Cited by 10 publications

References 9 publications

Intermittent Pneumatic Compression for the Prevention of Venous Thromboembolism after Total Hip Arthroplasty

Intermittent Pneumatic Compression for the Prevention of Venous Thromboembolism after Total Hip Arthroplasty

Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study

Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 2. Mechanical venous thromboembolism prophylaxis

Contact Info

Product

Resources

About