In the Journals

Study: Risk stratification protocol reduced rate of postoperative aggressive anticoagulation

Recently published results showed 70% of patients who underwent total hip or knee arthroplasty avoided more aggressive anticoagulation after the use of a risk stratification protocol for venous thromboembolism.

Researchers stratified 3,143 patients undergoing primary or revision knee or hip arthroplasty to either a routine risk (70.7%) or high risk (29.3%) venous thromboembolism (VTE) thromboprophylaxis regimen. Patients in the routine-risk group utilized a mobile compression device for 10 days and received aspirin twice daily for 6 weeks, and patients in the high-risk group received warfarin for 4 weeks and compression stockings for 6 weeks, according to researchers.

Within 6 weeks postoperatively, results showed the routine-risk cohort had a cumulative rate of VTE events of 0.7% vs. 0.5% in the high-risk cohort. Within 6 months postoperatively, the symptomatic VTE risk was 0.6% in the routine-risk cohort and 1.1% in the high-risk cohort, according to results.

Researchers found patients in the routine-risk cohort had a significantly lower rate of major bleeding and incidence of wound complications at 2 weeks. The routine-risk cohort also had a significantly lower risk of incisional draining lasting more than 3 days, results showed. At 2 weeks and 6 weeks postoperatively, researchers noted superior patient satisfaction scores among the routine-risk cohort vs. the high-risk cohort. – by Casey Tingle

 

Disclosures: Nam reports he is a paid consultant for KCI, has stock or stock options in OrthAlign Inc. and receives research support from EOS. Please see the full study for a list of all other authors’ relevant financial disclosures.

Recently published results showed 70% of patients who underwent total hip or knee arthroplasty avoided more aggressive anticoagulation after the use of a risk stratification protocol for venous thromboembolism.

Researchers stratified 3,143 patients undergoing primary or revision knee or hip arthroplasty to either a routine risk (70.7%) or high risk (29.3%) venous thromboembolism (VTE) thromboprophylaxis regimen. Patients in the routine-risk group utilized a mobile compression device for 10 days and received aspirin twice daily for 6 weeks, and patients in the high-risk group received warfarin for 4 weeks and compression stockings for 6 weeks, according to researchers.

Within 6 weeks postoperatively, results showed the routine-risk cohort had a cumulative rate of VTE events of 0.7% vs. 0.5% in the high-risk cohort. Within 6 months postoperatively, the symptomatic VTE risk was 0.6% in the routine-risk cohort and 1.1% in the high-risk cohort, according to results.

Researchers found patients in the routine-risk cohort had a significantly lower rate of major bleeding and incidence of wound complications at 2 weeks. The routine-risk cohort also had a significantly lower risk of incisional draining lasting more than 3 days, results showed. At 2 weeks and 6 weeks postoperatively, researchers noted superior patient satisfaction scores among the routine-risk cohort vs. the high-risk cohort. – by Casey Tingle

 

Disclosures: Nam reports he is a paid consultant for KCI, has stock or stock options in OrthAlign Inc. and receives research support from EOS. Please see the full study for a list of all other authors’ relevant financial disclosures.