|کد مقاله||کد نشریه||سال انتشار||مقاله انگلیسی||ترجمه فارسی||نسخه تمام متن|
|6000662||1182935||2016||6 صفحه PDF||ندارد||دانلود کنید|
â¢âEarlyâ VTE (in-hosp or â¤Â 7Â days) occurred in <Â 0.2% of fast-track THA and TKA.â¢âEarlyâ myocardial infarctions and ischemic strokes in <Â 0.1%â¢Most of âearlyâ VTE occurred while patients received recommended prophylaxis.â¢MIs were associated with severe postoperative anemia.
IntroductionThromboembolic events (TEE) are serious complications after total hip (THA) and knee arthroplasty (TKA), with reported in-hospital incidences of about 0.5â1% for venous thromboembolic events (VTE) and 0.2% for myocardial infarctions (MI) and stroke. However, little data exist on in-hospital TEE when using a standardized fast-track protocol with early mobilization.Materials and methodsA large detailed cohort study in primary unilateral THA and TKAs on âearlyâ (in-hospital or after discharge but within 1Â week of surgery) and 30-days TEEs, including prospective recording of patient characteristics, complete follow-up through the Danish National Patient Register, and detailed evaluation on disposing factors and consequences of âearlyâ TEEs through review of medical records.ResultsIn 13,775 procedures with a median LOS of 2Â days, 43 (0.32%; 95% CI: 0.23â0.42) âearlyâ and 90 (0.65%; 95% CI: 0.53â0.80) 30-day TEEs were recorded. âEarlyâ TEEs consisted of 9 (0.07%; 95% CI: 0.04â0.13) MI, 10 (0.08% 95% CI: 0.04â0.13) strokes, 13 (0.09%; 95% CI: 0.05â0.16) pulmonary embolisms and 11 (0.08%; 95% CI: 0.04â0.15) deep venous thromboses. Most TEEs were in patients with irreversible dispositions (e.g. previous TEE, high age and cardiac disease), but 5 of 9 MIs were associated with postoperative anemia. All in-hospital VTE (n: 16) occurred while patients received recommended thromboprophylaxis.ConclusionsIncidence of âearlyâ TEEs after fast-track THA and THA is low, but MIs may be further reduced by improving perioperative treatment of anemia. Further research is needed regarding interventions for prevention of âearlyâ TEE in disposed patients.
Journal: Thrombosis Research - Volume 138, February 2016, Pages 37-42