| Physician compliance with guidelines for deep-vein thrombosis prevention in total hip and knee arthroplasty. | |
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MedLine Citation:
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PMID: 18028586 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Despite evidence-based guidelines for venous thromboembolism (VTE) prevention after total hip or knee arthroplasty (THA/TKA), many patients may not receive effective prophylaxis. Our objective was to analyze data from the multinational Global Orthopaedic Registry (GLORY) to evaluate the compliance of surgeons with the American College of Chest Physicians (ACCP) guidelines for VTE prevention. RESEARCH DESIGN AND METHODS: Data from 8160 patients who had undergone a primary, unilateral, elective THA (n = 3950) or TKA (n = 4210), and had at least 3 months of follow-up were analyzed. RESULTS: Almost all patients received a form of recommended prophylaxis. Compliance with guidelines in terms of type, duration, start time, and dose was achieved for 47% of THA and 61% of TKA patients in the USA, and 62% of THA and 69% of TKA patients outside the USA. Warfarin use, mostly in the USA, was fully compliant in 33% of THA and 48% of TKA patients. Low-molecular-weight heparin use was fully compliant in 63% of THA and 72% of TKA patients in the USA, and 67% of THA and 73% of TKA patients outside the USA. CONCLUSION: Although almost all THA and TKA patients both inside and outside the USA received prophylaxis, a large proportion did not receive treatment in accordance with the ACCP guidelines. Our study may have overestimated the use of recommended prophylaxis as some participating investigators may have had a specific interest in VTE prophylaxis. Furthermore, although analyses were restricted to approximately three-quarters of patients who had outpatient follow-up data, their characteristics were similar to those in the entire population. |
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Authors:
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Richard J Friedman; Alexander S Gallus; Fred D Cushner; Gordon Fitzgerald; Frederick A Anderson; |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Current medical research and opinion Volume: 24 ISSN: 1473-4877 ISO Abbreviation: Curr Med Res Opin Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-07 Completed Date: 2008-02-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0351014 Medline TA: Curr Med Res Opin Country: England |
Other Details:
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Languages: eng Pagination: 87-97 Citation Subset: IM |
Affiliation:
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Charleston Orthopedic Associates, Charleston, SC 29414, USA. rjfriedman@mybones.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arthroplasty, Replacement, Hip / methods* Arthroplasty, Replacement, Knee / methods* Female Follow-Up Studies Guideline Adherence* Health Planning Guidelines Humans Male Middle Aged Physicians* Societies, Medical Venous Thromboembolism / prevention & control Venous Thrombosis / prevention & control* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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