Thromboprophylaxis in Proximal Femur Fracture: A Pilot Survey among Practicing Orthopaedic Surgeons in India
Introduction: Venous Thromboembolism (VTE) and Pulmonary Embolism (PE) are more common following orthopaedic surgeries around the hip than other surgeries. However, there is still a dilemma among orthopaedic surgeons regarding whether routine thromboprophylaxis is justified in patients. Aim: To...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18483/62442_CE[Ra1]_F(IS)_QC(SD_RDW_IS)_PF1(RI_SS)_PFA_NC(RI_KM)_PN(KM).pdf |
| Summary: | Introduction: Venous Thromboembolism (VTE) and Pulmonary
Embolism (PE) are more common following orthopaedic
surgeries around the hip than other surgeries. However, there is
still a dilemma among orthopaedic surgeons regarding whether
routine thromboprophylaxis is justified in patients.
Aim: To describe current practices among orthopaedic surgeons
regarding routine thromboprophylaxis among patients with
proximal femur fractures.
Materials and Methods: A cross-sectional exploratory study
was conducted at Department of Orthopaedics, Saveetha
Medical College, Chennai, Tamil Nadu, India between March
2022 and May 2022 among orthopaedic surgeons. A Google
survey form, containing 10 prevalidated multiple-choice
questions, was shared on social media and medical groups.
Descriptive analysis was undertaken, and statistical analysis
was done with International Business Machines (IBM) Statistical
Package for Social Sciences (SPSS) software version 28.0.
Results: Among the 141 respondents, 72% were from private
sector institutions/hospitals. Over 90.78% of the respondents
indicated that there was a role for anticoagulation therapy in
proximal femur fractures, and 92% used low molecular weight
heparin. The responses varied slightly depending on whether
anticoagulant treatment was used preoperatively (51%) or
postoperatively (48%), and if there was a waiting time of less than
24 hours to 3-5 days before surgery. Most orthopaedic surgeons
opted for anticoagulation therapy in the presence of a previous
history of Deep Vein Thrombosis (DVT)/PE (79%), age greater
than 70 years (61%), and use of hormone replacement therapy
(64%), or if the surgery lasted more than two hours (61%).
Conclusion: The present study concludes that 9.2% of
orthopaedic surgeons do not use anticoagulation therapy and
nearly half (48%) do not administer anticoagulation therapy
preoperatively. As the proportion of elderly patients increases,
consensus building will enable the formulation of practice
guidelines based on evidence generated through such surveys. |
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| ISSN: | 2249-782X 0973-709X |