Venous Thromboembolism Prophylaxis in Orthopedic Surgery
Comparative Effectiveness of Mechanical Prophylaxis Versus No Thromboprophylaxis
One randomized controlled trial showed that mechanical prophylaxis versus no prophylaxis significantly decreased deep vein thrombosis in patients undergoing major orthopedic surgery. Mechanical prophylaxis versus no prophylaxis does not significantly impact proximal deep vein thrombosis or distal deep vein thrombosis in patients undergoing major orthopedic surgery.
No data are available to evaluate the comparative effect of mechanical prophylaxis versus no prophylaxis on symptomatic, objectively confirmed venous thromboembolism, major venous thromboembolism, post-thrombotic syndrome, mortality, mortality due to bleeding, health-related quality of life, asymptomatic deep vein thrombosis, symptomatic deep vein thrombosis, major bleeding, major bleeding leading to reoperation, minor bleeding, surgical site bleeding, bleeding leading to infection, bleeding leading to transfusion, heparin-induced thrombocytopenia, discomfort, reoperation, and readmission in patients undergoing major orthopedic surgery. The comparative impact of mechanical prophylaxis versus no prophylaxis on pulmonary embolism, fatal pulmonary embolism, and nonfatal pulmonary embolism could not be determined because no events occurred in the two comparative groups in the available trials.
- Sobieraj DM, Coleman CI, Tongbram V, et al. Venous Thromboembolism in Orthopedic Surgery. Comparative Effectiveness Review No. 49 (Prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center under Contract No. 290-2007-10067-I). Rockville, MD: Agency for Healthcare Research and Quality; March 2012. AHRQ Publication No. 12-EHC020-EF. Available at www.effectivehealthcare.ahrq.gov/thrombo.cfm.
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