Prevention of Venous Thromboembolism in Major Orthopaedic Surgery The 8th ACCP Guidelines COA

Description: Rationale for Routine Thromboprophylaxis in Major Orthopaedic Surgery
Because venous thromboembolism (VTE) is one of the most common complications following major orthopaedic surgery and is associated with both short- and long-term morbidity and occasional fatal outcome, routine prophylaxis has been the key to reducing the burden of this disease for more than 20 years. Numerous clinical trials confirm the effectiveness, safety, and cost-effectiveness of thromboprophylaxis in a broad spectrum of patient groups. The use of thromboprophylaxis has been shown to reduce the risk of DVT, proximal DVT, PE, and fatal PE by more than 60% while the risk of clinically-important bleeding is low with anticoagulant prophylaxis and is similar to the risk seen in patients not receiving prophylaxis or receiving mechanical prophylaxis1. Orthopaedic surgery is the clinical area with the highest thrombosis risk, the largest number of recent clinical trials and with the greatest adherence to recommended prophylaxis. With the routine use of thromboprophylaxis in these patients, fatal PE is very uncommon, although symptomatic VTE continues to be reported in 1-5% of arthroplasty patients within three months after surgery.
The ACCP Guidelines on the Prevention of VTE in Orthopaedic Surgery
The American College of Chest Physicians (ACCP) Guidelines on the Prevention of VTE are prepared by a multidisciplinary, international group of clinician-methodologists, including orthopaedic surgeons.
William Geerts, M.D. COA Bulletin Issue 83 2008