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deep vein thrombosis prophylaxis

Anat Rabinovich, Susan R Kahn
The post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that imposes significant morbidity, reduces quality of life and is costly. After DVT, 20-50% of patients will develop PTS, and up to 5% will develop severe PTS. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, obesity and older age. By preventing the initial DVT and DVT recurrence, primary and secondary prophylaxis of DVT will reduce the occurrence of PTS. The effectiveness of elastic compression stockings (ECS) for PTS prevention is controversial...
March 15, 2018: Blood
Nitin Agarwal, Georgios A Zenonos, Prateek Agarwal, Frank J Walch, Eileen Roach, Sandra J Stokes, Robert M Friedlander, Peter C Gerszten
BACKGROUND: Pharmacological prophylaxis for venous thromboembolism (VTE) in the neurosurgical population is still a matter of debate, as the risk-to-benefit ratio is not well defined. OBJECTIVE: To further evaluate the risk-to-benefit ratio of VTE prophylaxis (VTEP) for all neurosurgical procedures. METHODS: A prospective evaluation was performed after the initiation of a VTEP protocol for 11 436 patients undergoing neurosurgical procedures over 24 mo...
March 9, 2018: Neurosurgery
A Kotaska
Based on prediction models and expert opinion, most obstetric venous thromboembolism guidelines recommend low-molecular-weight heparin for many postpartum women, including most delivering by caesarean. Scrutiny reveals major oversights: prediction models are based on studies that report asymptomatic deep vein thrombosis; risk estimates are not adjusted for time exposure; and harm caused by heparin has been overlooked. The benefits of heparin are exaggerated and its harms are under-appreciated. Estimates of the numbers-needed-to-treat and harm are universally lacking...
March 7, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Ben Jacobs, Peter K Henke
Venous thromboembolism (VTE) remains a significant mortal and morbid disease. The major risks have not changed and many patients present with unprovoked VTE disease. Prevention of VTE in hospitalized patients depends on comprehensive risk factor assessment, with an individual risk score. Proper and timely prophylaxis with mechanical, pharmacologic, or both is then effective. Treatment of VTE with parenteral anticoagulation followed by either a direct oral anticoagulant or warfarin is standard to reduce risk of VTE recurrence and death...
April 2018: Surgical Clinics of North America
Ameer M Elbuluk, Kelvin Y Kim, Kevin K Chen, Afshin A Anoushiravani, Ran Schwarzkopf, Richard Iorio
The objective of this study was to evaluate the efficacy of respiratory synchronized compression devices (RSCDs) versus nonsynchronized intermittent pneumatic compression devices (NSIPCDs) in preventing venous thromboembolism (VTE) after total joint arthroplasty. A systematic literature review was conducted. Data regarding surgical procedure, deep vein thrombosis, pulmonary embolism, mortality, and adverse events were abstracted. Compared with control groups, the risk ratio of deep vein thrombosis development was 0...
April 2018: Orthopedic Clinics of North America
Alanna O'Brien, Bernice Redley, Beverley Wood, Mari Botti, Anastasia F Hutchinson
AIMS AND OBJECTIVES: The purpose of this research was to develop and test a clinical tool to guide nurses' assessment of postoperative patients for Deep Vein Thrombosis (DVT). BACKGROUND: Preventing venous thromboembolism (VTE) in hospitalised patients is an international patient safety priority. Despite high-level evidence for optimal VTE prophylaxis, implementation is inconsistent and the incidence of Deep Vein Thrombosis (DVT) remains high. METHODS: A two stage sequential multi-method design was used...
March 1, 2018: Journal of Clinical Nursing
David R Anderson, Michael Dunbar, John Murnaghan, Susan R Kahn, Peter Gross, Michael Forsythe, Stephane Pelet, William Fisher, Etienne Belzile, Sean Dolan, Mark Crowther, Eric Bohm, Steven J MacDonald, Wade Gofton, Paul Kim, David Zukor, Susan Pleasance, Pantelis Andreou, Steve Doucette, Chris Theriault, Abongnwen Abianui, Marc Carrier, Michael J Kovacs, Marc A Rodger, Doug Coyle, Philip S Wells, Pascal-Andre Vendittoli
BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty...
February 22, 2018: New England Journal of Medicine
Frank Daniel Martos-Benítez, Anarelys Gutiérrez-Noyola, Andrés Soto-García, Iraida González-Martínez, Ilionanys Betancourt-Plaza
Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January-2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit...
February 10, 2018: Updates in Surgery
Fadwa Ali, Sadeer G Al-Kindi, Jacqueline J Blank, Carrie Y Peterson, Kirk A Ludwig, Timothy J Ridolfi
BACKGROUND: The risk of postoperative venous thromboembolism is high in patients with colon cancer and IBD. Although The American Society of Colon and Rectal Surgeons suggests posthospital prophylaxis after surgery in patients with colon cancer, there are no such recommendations for patients with IBD. OBJECTIVE: This study aims to analyze the incidence and risk factors for postoperative venous thromboembolism. DESIGN: This was a retrospective review using the Explorys platform...
March 2018: Diseases of the Colon and Rectum
Farzaneh Ashrafi, Najmeh Rezaie, Sarah Mousavi
Objective: Dabigatran etexilate is a novel oral anticoagulant with several advantages over warfarin such as no need for routine monitoring and fewer drug interactions. This drug was added to our hospital's formulary in 2012. The objective of this study was to assess the rational drug use of dabigatran at a large teaching hospital. Methods: A prospective cross-sectional study was performed from November to June 2015 at Alzahra teaching hospital, Isfahan, Iran. All patients who received at least one dose of dabigatran were eligible for inclusion...
October 2017: Journal of Research in Pharmacy Practice
Dawn M Bravata, Laura J Myers, Greg Arling, Edward J Miech, Teresa Damush, Jason J Sico, Michael S Phipps, Alan J Zillich, Zhangsheng Yu, Mathew Reeves, Linda S Williams, Jason Johanning, Seemant Chaturvedi, Fitsum Baye, Susan Ofner, Curt Austin, Jared Ferguson, Glenn D Graham, Rachel Rhude, Chad S Kessler, Donald S Higgins, Eric Cheng
Importance: The timely delivery of guideline-concordant care may reduce the risk of recurrent vascular events for patients with transient ischemic attack (TIA) and minor stroke. Although many health care organizations measure stroke care quality, few evaluate performance for patients with TIA or minor stroke, and most include only a limited subset of guideline-recommended processes. Objective: To assess the quality of guideline-recommended TIA and minor stroke care across the Veterans Health Administration (VHA) system nationwide...
February 5, 2018: JAMA Neurology
Jonathan K Aboagye, Jeremiah W A Hayanga, Brandyn D Lau, Errol L Bush, Dauryne L Shaffer, Deborah B Hobson, Peggy S Kraus, Michael B Streiff, Elliott R Haut, Jonathan D'Cuhna
BACKGROUND: Venous thromboembolism (VTE) is an important complication after solid organ transplantation. We sought to evaluate any association between VTE and in-hospital death, length of hospitalization, and total hospital charges for patients hospitalized for lung transplantation (LT). METHODS: We retrospectively reviewed the Nationwide Inpatient Sample to identify patients hospitalized for LT from 2000 to 2011. We evaluated the incidence of VTE during hospitalization for LT, risk factors for VTE, and the association between VTE and in-hospital death, length of hospitalization, and total hospital charges...
January 29, 2018: Annals of Thoracic Surgery
Abhilash Koratala, Deepti Bhattacharya
Heparin is an anticoagulant, which is frequently used in hospitalized patients for prophylaxis of deep vein thrombosis (DVT). Subcutaneous administration of heparin may lead to complications such as bruising, hematoma, and pain at the injection site. Hematomas can develop without visible bruising, as in our case.
January 2018: Clinical Case Reports
Sosthene Tsongo Vululi, Samuel Bugeza, Muyinda Zeridah, Henry Ddungu, Akello Betty Openy, Mubiru Frank, Rosalind Parkes-Ratanshi
BACKGROUND: Deep venous thrombosis (DVT) and its major complication pulmonary embolism (PE) are collectively known as venous thromboembolism. In Uganda, the prevalence of DVT among HIV patients has not been previously published. The aim of the study was to determine the prevalence and sonographic features of lower limb deep venous thrombosis among HIV positive patients on anti-retroviral treatment (ART). METHODS: This was a cross sectional study in which HIV positive patients on ART were recruited from an out-patient HIV clinic at Mulago National Referral Hospital...
January 25, 2018: AIDS Research and Therapy
Jose Luiz Colleoni, Fernando Noel Ribeiro, Paulo Augusto Castro Mos, João Paulo Reis, Henrique Rosa de Oliveira, Beatriz Kawata Miura
Objectives: To compare the efficacy and safety of aspirin and rivaroxaban in preventing venous thromboembolism (VTE) after total knee arthroplasty (TKA). Methods: Thirty-two patients with osteoarthritis of the knee and knee arthroplasty indication were selected. The operated patients were randomized into two groups (A and B). Group A received 300 mg of acetylsalicylic acid (aspirin) and Group B received 10 mg of rivaroxaban daily for 14 days. Follow-up was performed weekly for four weeks and evaluated the presence of signs and symptoms of DVT, the healing of the surgical wound, and possible local complications such as hematoma, and superficial or deep infection that required surgical approach...
January 2018: Revista Brasileira de Ortopedia
Michelle Shen, Norele J Cutrera, Ashley C Dodd, Christopher Wallace, Frank R Avilucea, Craig Melbourne, Alex A Jahangir, Hassan H Mir, William T Obremskey, Manish K Sethi
Background: The development of Deep Vein Thrombosis (DVT) is a major concern following orthopaedic surgery. No study has yet to compare the rate and risk factors for DVT between total joint and orthopaedic trauma patients. To evaluate if DVT prophylaxis for trauma should differ from total joints, we explored the rate and risk factors for DVT between both cohorts. Methods: Using a CPT code search from 2005 to 2013 in the ACS-NSQIP database, 150,657 orthopaedic total joint patients and 44,594 orthopaedic trauma patients were identified...
November 2017: Journal of Clinical Orthopaedics and Trauma
Keith J Ruskin
PURPOSE OF REVIEW: Deep vein thrombosis (DVT) and pulmonary embolus are major causes of hospital-related morbidity and mortality, and are recognized as complications in patients with traumatic injury. Despite the significant morbidity and mortality associated with DVTs, prophylaxis and treatment are still not well understood and remain the subject of research and debate. RECENT FINDINGS: Elements of the patient's history and physical examination, along with thromboelastography, can be used to predict patients who are at greatest risk of DVT and venous thromboembolism (VTE)...
January 12, 2018: Current Opinion in Anaesthesiology
Peter M Bonutti, Nipun Sodhi, Yatindra H Patel, Assem A Sultan, Anton Khlopas, Morad Chughtai, Frank R Kolisek, Nick Williams, Michael A Mont
Background: Despite the demonstrated success of multiple anticoagulation therapies for post-operative prophylaxis of thromboembolic disease in lower extremity arthroplasties, each modality comes with a unique set of limitations. Thus, the ideal anticoagulation medication which provides adequate therapy with minimal cost, complications, or added patient work is yet to be defined. One promising novel thrombophylactic supplement is fish oil, as many preliminary clinical trials have demonstrated a protective effect of fish oil against thrombosis in multiple clinical settings...
December 2017: Annals of Translational Medicine
Keisuke Nakanishi, Naonobu Takahira, Miki Sakamoto, Minako Yamaoka-Tojo, Masato Katagiri, Jun Kitagawa
INTRODUCTION: Patients with plaster cast immobilization of the lower limb have an estimated symptomatic venous thromboembolism rate of 5.5%. However, there is currently no practical physical prophylaxis for deep-vein thrombosis (DVT). The objective of this study was to examine the effects of forced deep breathing on peak blood velocity in the superficial femoral vein (PBVFV), which is a surrogate measure of the efficacy of thromboprophylaxis against DVT, in patients with plaster cast immobilization of the lower limb...
December 23, 2017: Thrombosis Research
Nagarajan Ramakrishnan, Detect-Dvt Investigators
Purpose: To assess thromboprophylaxis rate and incidence of symptomatic deep vein thrombosis (DVT) in Indian patients with acute sepsis. Materials and Methods: Adult patients with sepsis, within 48 h of sepsis onset/hospital admission were included. DVT was assessed using Doppler ultrasonography if clinical signs were present. Data were collected at inclusion, discharge, and 30 ± 7 days (if discharged before 30 days). Results: The study included 278 patients (men: 69...
November 2017: Indian Journal of Critical Care Medicine
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