Document Detail

The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients.
MedLine Citation:
PMID:  19407300     Owner:  NLM     Status:  MEDLINE    
We studied 4253 patients undergoing primary joint replacement between November 2002 and November 2007, of whom 4060 received aspirin only as chemical prophylaxis; 46 were mistakenly given low molecular weight heparin initially, which was stopped and changed to aspirin; 136 received no chemoprophylaxis and 11 patients received warfarin because of a previous history of pulmonary embolism. We identified the rate of clinical thromboembolism before and after discharge, and the mortality from pulmonary embolism at 90 days. The overall death rate was 0.31% (13 of 4253) and the rate of fatal pulmonary embolism was 0.07% (3 of 4253). Our data suggest that fatal pulmonary embolism is not common following elective primary joint replacement, and with modern surgical practice elective hip and knee replacement should no longer be considered high-risk procedures.
L A Cusick; D E Beverland
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  91     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-06-01     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  645-8     Citation Subset:  AIM; IM    
Orthopaedic Outcomes Department, Musgrave Park Hospital, Belfast, Northern Ireland.
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MeSH Terms
Aged, 80 and over
Anticoagulants / therapeutic use*
Arthroplasty, Replacement, Hip / adverse effects,  mortality*
Arthroplasty, Replacement, Knee / adverse effects,  mortality*
Aspirin / therapeutic use
Fibrinolytic Agents / therapeutic use*
Heparin, Low-Molecular-Weight / therapeutic use
Middle Aged
Prospective Studies
Pulmonary Embolism / epidemiology,  mortality*
Thromboembolism / epidemiology
Warfarin / therapeutic use
Young Adult
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 50-78-2/Aspirin; 81-81-2/Warfarin

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