Worldwide adherence to ACCP guidelines for thromboprophylaxis after major orthopedic surgery: A systematic review of the literature and meta-analysis

Farfan, Miguel Andres; Bautista, María; Bonilla, Guillermo; Rojas, Jorge; Llinás, Adolfo; Navas, José María Pedrajas

doi:10.1016/j.thromres.2016.03.029

Cited by 44 publications

(40 citation statements)

References 40 publications

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“…[18–20] Indeed, pharmacological VTE prophylaxis is a standard component of the protocol of care for orthopedic patients. [5] …”

Section: Discussionmentioning

confidence: 99%

“…[2,3] However, the advantage of neuraxial blockade with respect to VTE may no longer be relevant because of advances made in general anesthesia and pharmacological and mechanical thromboprophylaxis. [4,5] Furthermore, extended neuraxial blockade, such as that required for epidural analgesia, may delay the initiation of postsurgical pharmacological prophylaxis owing to the associated risk of spinal and/or epidural hematoma, possibly leading to a permanent neurological deficit, such as paraplegia. [6] There are no specific clinical guidelines for the choice of anesthesia, largely because of insufficient recent evidence from studies comparing general anesthesia and neuraxial blocks for their association with VTE.…”

Section: Introductionmentioning

confidence: 99%

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Spinal anesthesia increases the risk of venous thromboembolism in total arthroplasty

et al. 2017

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Clinical guidance on the choice of anesthetic modality vis-à-vis the risk of perioperative venous thromboembolism (VTE) is largely lacking because of a paucity of recent evidence. A comparative effect of general anesthesia and neuraxial blockade on the perioperative incidence of VTE has not been well-investigated.We compared the effects of different types of anesthetic modalities on the risk of VTE after total hip arthroplasty (THA) and total knee arthroplasty (TKA).This is a secondary analysis of the Japanese Study of Prevention and Actual Situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT). Data pertaining to a total of 2162 patients who underwent THA and TKA at 34 hospitals were included in this analysis. We compared the different anesthetic modalities with respect to the incidence of VTE. The composite end-point was asymptomatic/symptomatic deep vein thrombosis detected using scheduled bilateral ultrasonography up to postoperative day (POD) 10 and fatal/non-fatal pulmonary embolism up to POD 10.The study groups were as follows: general anesthesia (n = 646), combined epidural/general anesthesia (n = 1004), epidural anesthesia (n = 87), and spinal anesthesia (n = 425). On multivariate analysis, only spinal anesthesia was associated with a significant increase in the risk of VTE as compared with that associated with general anesthesia. Propensity score-matched analysis for “combined epidural/general anesthesia group” versus “spinal anesthesia group” demonstrated a 48% higher incidence of VTE (relative risk = 1.48, 95% confidence interval [CI] 1.18–1.85) in the latter.Spinal anesthesia was associated with a higher risk of postoperative VTE, as compared with that associated with combined epidural/general anesthesia, in patients undergoing total arthroplasty.

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“…[18–20] Indeed, pharmacological VTE prophylaxis is a standard component of the protocol of care for orthopedic patients. [5] …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spinal anesthesia increases the risk of venous thromboembolism in total arthroplasty

et al. 2017

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“…There is considerable debate regarding the preferred thromboprophylactic agent during primary TKA, much of which stems from limitations in studies [4,25,36]. For example, while the American Academy of Orthopaedic Surgeons [2] and the American College of Chest Physicians [13] recommend the use of thromboprophylaxis during the perioperative period, despite analysis of many studies, there currently is no consensus regarding the preferred therapeutic agent, especially when considering the balance between VTE prevention and potential bleeding complications [14,26,36]. Novel anticoagulants such as factor Xa inhibitors have further confused the discussion regarding the preferred treatment after primary TKA [28,32].…”

Section: Introductionmentioning

confidence: 99%

Venous Thromboembolism Prophylaxis After TKA: Aspirin, Warfarin, Enoxaparin, or Factor Xa Inhibitors?

Bala

Huddleston

Goodman

et al. 2017

Clinical Orthopaedics &Amp; Related Research

117

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“…13 This trend of nonadherence and variation does not represent a recent or urology-specific phenomenon and has been shown in other specialties such as psychiatry, neurosurgery, or orthopedics. [20][21][22] We demonstrate that PTP utilization peaked around the time of the publication of the AUA best practice statement and decreased about 1 year later (Fig. 2).…”

Section: Discussionmentioning

confidence: 75%

Trends in Adherence to Thromboprophylaxis Guideline in Patients Undergoing Radical Cystectomy

Tully

Krimphove

Reese

et al. 2020

Urology

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Worldwide adherence to ACCP guidelines for thromboprophylaxis after major orthopedic surgery: A systematic review of the literature and meta-analysis

Cited by 44 publications

References 40 publications

Spinal anesthesia increases the risk of venous thromboembolism in total arthroplasty

Spinal anesthesia increases the risk of venous thromboembolism in total arthroplasty

Venous Thromboembolism Prophylaxis After TKA: Aspirin, Warfarin, Enoxaparin, or Factor Xa Inhibitors?

Trends in Adherence to Thromboprophylaxis Guideline in Patients Undergoing Radical Cystectomy

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