Profilaxia do tromboembolismo venoso em cirurgia ortopédica

Sguizzatto, Guilherme Turolla

doi:10.1590/s0102-36162012000600002

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…(venous thromboembolism, pressure ulcers, and pneumonia within 30 days). 3 The risk of death remains even after hospital discharge; however, mortality rates varied greatly in the literature consulted. A study conducted in Brazilian hospital in 2007 observed mortality of up to 36% 24 months after fracture, and 60% 48 months after the occurrence.…”

Section: Resultsmentioning

confidence: 99%

“…Compararam-se pacientes que apresentaram óbito intra-hospitalar (grupo caso) com pacientes que não apresentaram óbito hospitalar (grupo controle) quanto à exposição a fatores de risco prévios à lesão e fatores relacionados ao tratamento ortopédico. Resultados: Os fatores relacionados a uma maior taxa de mortalidade intra-hospitalar foram: gênero masculino (grupo caso: 52%; controle: 26%; p = 0,005), menor escore de Parker (grupo caso: 5,0 pontos; controle: 6,2 pontos; p = 0,048), delirium na admissão (grupo caso: 26%; controle: 10%; p = 0,011); delirium desenvolvido durante a internação (grupo caso: 77%; controle: 35%; p < 0,001), e tempo até a cirurgia (13,3 dias vs. 9,1 dias; p = 0,049). Conclusão: No presente estudo, a taxa de mortalidade intra-hospitalar em pacientes com fratura proximal do fêmur foi de 8%, e os principais fatores de risco associados a esse desfecho foram o gênero masculino, escore de…”

Section: Introductionunclassified

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Evaluation of Predictive Factors of in Hospital Mortality in Patients With Proximal Femoral Fracture

et al. 2020

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Objective: To investigate the existence of a causal association between orthopedic treatment and the occurrence of in hospital death. Methods: 338 patients with proximal femoral fracture were evaluated, of whom 27 faced in hospital death. Patients who faced in hospital death (case group) were compared to patients who did not (control group) regarding exposure to risk factors prior to injury and factors related to orthopedic treatment. Results: The factors related to higher in hospital mortality rate were: male sex (case group: 52%, control: 26%; p = 0.005), lower Parker’s score (case group: 5.0 points, control: 6.2; p = 0.048), delirium on admission (case group: 26%, control: 10%; p = 0.011); delirium developed during hospitalization (case group: 77%, control: 35%; p <0.001), and time until surgery (13.3 days, 9.1; p = 0.049). Conclusion: The in hospital mortality rate of patients with proximal femoral fracture was 8%, and the main associated risk factors were male sex, reduced Parker’s score, delirium diagnosed on hospital admission or developed during hospitalization, and time until surgery. Level of Evidence III, Case control study.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionunclassified

Evaluation of Predictive Factors of in Hospital Mortality in Patients With Proximal Femoral Fracture

et al. 2020

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“…VTE is the most frequent postoperative complication in general orthopedic surgery, resulting in significant morbidity and mortality [1]. While VTE can develop after any major surgery, the incidence of VTE among orthopedic patients is substantially higher, particularly among recipients of hip and knee arthroplasty [2,3]. Underlining the importance of prevention and prophylaxis, the mortality of pulmonary embolism (PE) following diagnosis may be as high as 30%, particularly among the geriatric population [4].…”

Section: General Principlesmentioning

confidence: 99%

Review of Therapeutic Options for the Prevention of VTE in Total Joint Arthroplasty

et al. 2020

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Hip and knee arthroplasty patients are at high risk of perioperative venous thromboembolic events (VTE). VTE has been well studied in this population and it is recommended that total joint arthroplasty recipients receive chemoprophylactic anticoagulation due to risk factors inherent to the surgical intervention. There are few concise resources for the orthopedic surgeon that summarize data regarding post-operative anticoagulation in the context of currently available therapeutic options and perioperative standards of practice. The periodic reexamination of literature is essential as conclusions drawn from studies predating perioperative protocols that include early mobilization and sequential compression devices as standards of practice in total joint arthroplasty are no longer generalizable to modern-day practice. We reviewed a large number of recently published research studies related to post-operative anticoagulation in total joint arthroplasty populations that received a high Level of Evidence grade. Current literature supports the use of oral aspirin regimens in place of more aggressive anticoagulants, particularly among low risk patients. Oral aspirin regimens appear to have the additional benefit of lower rates of bleeding and wound complications. Less consensus exists among high risk patients and more potent anticoagulants may be indicated. However, available evidence does not demonstrate clear superiority among current options, all of which may place patients at a higher risk of bleeding and wound complications. In this situation, chemoprophylactic selection should reflect specific patient needs and characteristics.

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“…A utilização de bota de retorno venoso e as meias compressivas no paciente cirúrgico, no intraoperatório e pós-operatório, mostram-se eficazes no que diz respeito à prevenção de TVP, visto que auxiliam o fluxo sanguíneo e, consequentemente, diminuem a estase venosa, um dos fatores de risco para o desenvolvimento da trombose [16][17] . Alguns participantes da pesquisa citaram o uso de meias compressivas quando possível, caso não tenha contraindicação para determinado paciente.…”

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Papel do enfermeiro no período perioperatório para prevenção da trombose venosa profunda

2016

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Objetivos: Conhecer como os enfermeiros realizam a prevenção da Trombose Venosa Profunda (TVP) em pacientes submetidos a cirurgias de grande porte no período perioperatório; e levantar os fatores de risco para o desenvolvimento de TVP identificados pelos enfermeiros. Método: Estudo de caso com abordagem qualitativa. Amostra composta por 12 enfermeiros da unidade de internação, centro cirúrgico e sala de recuperação pós-anestésica de um hospital especializado em trauma de Porto Alegre (RS). Utilizou-se entrevista semiestruturada com 10 questões norteadoras. Para interpretação dos dados utilizou-se Análise de Conteúdo de Bardin. Resultados: Emergiram três categorias: Fatores de Risco para TVP; Medidas Preventivas de TVP e Dificuldades na Execução da Sistematização da Assistência de Enfermagem Perioperatória. Conclusão: Os enfermeiros realizam prevenção de TVP com massagem, observação, exame físico/avaliação, medidas protetivas e mudança de posição, entretanto falta autonomia para aplicar algumas medidas preventivas. Apontaram vários fatores de risco para a ocorrência de TVP conforme literatura, evidenciando conhecimento sobre a patologia. Palavras-chave: Trombose venosa. Enfermagem perioperatória. Prevenção de Doenças.

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Profilaxia do tromboembolismo venoso em cirurgia ortopédica

Cited by 11 publications

References 18 publications

Evaluation of Predictive Factors of in Hospital Mortality in Patients With Proximal Femoral Fracture

Evaluation of Predictive Factors of in Hospital Mortality in Patients With Proximal Femoral Fracture

Review of Therapeutic Options for the Prevention of VTE in Total Joint Arthroplasty

Papel do enfermeiro no período perioperatório para prevenção da trombose venosa profunda

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