Patient Safety- Clinical

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Readmissions After Elective Total Joint Arthroplasty

For total hip arthroplasty (THA), the overall pooled readmission rate was 5.6% at 30 days and 7.7% at 90 days

The DVT rate for the post-discharge protocol of Aspirin and Portable Mechanical Compression therapy group was 0%. The DVT rate for the post-discharge protocol of just Aspirin group was 23.1%

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh

Preventing Deep Vein Thrombosis in Hospital Patients

Most hospital inpatients are at risk of DVT and the associated complications of fatal or non-fatal pulmonary embolism and post-thrombotic syndrome

In patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), we recommend use of one of the following for a minimum of 10 to 14 days rather than no antithrombotic prophylaxis: low-molecular-weight heparin (LMWH), fondaparinux, apixaban, dabigatran, rivaroxaban, low-dose unfractionated heparin (LDUH), adjusted-dose vitamin K antagonist (VKA), aspirin (all Grade 1B), or an intermittent pneumatic compression device (IPCD) (Grade 1C).

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh

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Thromboprophylacis in Orthopedic Surgery

45% to 80% of all symptomatic VTE events occur after hospital discharge

We suggest the use of pharmacologic agents and/or mechanical compressive devices for the prevention of venous thromboembolic disease in patients undergoing elective hip or knee arthroplasty, and who are not at elevated risk beyond that of the surgery itself for venous thromboembolism or bleeding.

 

Grade of Recommendation: Moderate

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh