Postdischarge thromboprophylaxis and mortality risk after hip-or knee-replacement surgery

Outpatient thromboprophylaxis after hip or knee surgery: discrepancies and concerns

“…6 Over 80% of these patients did not receive thromboprophylaxis after discharge. There appears to be increased risk of short-term mortality among patients who did not receive postdischarge thromboprophylaxis compared with those who did.…”

Combined Short Course Low Molecular Weight Heparin and Calf Compression Therapy in Prevention of Deep Vein Thrombosis after Total Knee Replacement: A Randomized Prospective Study

“…entire cohort >61 years old and undergoing elective arthroplasty) reported significantly higher short term mortality secondary to VTE amongst patients who failed to continue with chemo-prophylaxis post discharge (mean discharge time being 7 days) compared with those who continued therapy for a minimum of ten-fourteen days (4.2% mortality vs. 0.7% mortality) [28]. Metaanalyses of nine randomized control trials have also demonstrated clear superiority of extended thromboprophylaxis (for 30-42 days postoperative) in achieving 51% risk reduction of venography confirmed DVT and 61% risk reduction in incidence of symptomatic VTE compared with short course therapy, though these studies focused on patients undergoing total hip replacement.…”

Retrospective Analysis of Adherence to Thromboprophylaxis after Orthopedic Surgery in a Community Hospital

“…3 The results of studies evaluating in-hospital adherence to available guidelines have been disappointing, with most adherence rates being suboptimal. [4][5][6][7] Adherence with postdischarge thromboprophylaxis is also important, given reports that the majority of cases of thromboembolism after total hip and knee replacement are diagnosed after discharge. 8 The primary objective of this retrospective analysis was to examine the rate of adherence to the 2008 ACCP guidelines for the appropriate duration of postoperative therapy with LMWH or warfarin among orthopedic patients in an urban community hospital.…”