The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis.
Recent recommendations by the National Institute for Health and Care Excellence (NICE) suggest that all patients undergoing elective orthopaedic surgery should be assessed for the risk of venous thromboembolism (VTE). Little is known about the incidence of symptomatic VTE after elective external fix...
| Автори: | , , , |
|---|---|
| Формат: | Journal article |
| Мова: | English |
| Опубліковано: |
Journal of Bone and Joint Surgery Inc.
2014
|
| _version_ | 1826286020910383104 |
|---|---|
| author | Ferguson, J Sutherland, M Pandit, H McNally, M |
| author_facet | Ferguson, J Sutherland, M Pandit, H McNally, M |
| author_sort | Ferguson, J |
| collection | OXFORD |
| description | Recent recommendations by the National Institute for Health and Care Excellence (NICE) suggest that all patients undergoing elective orthopaedic surgery should be assessed for the risk of venous thromboembolism (VTE). Little is known about the incidence of symptomatic VTE after elective external fixation. We studied a consecutive series of adult patients who had undergone elective Ilizarov surgery without routine pharmacological prophylaxis to establish the incidence of symptomatic VTE. A review of a prospectively maintained database of consecutive patients who were treated between October 1998 and February 2011 identified 457 frames in 442 adults whose mean age was 42.6 years (16.0 to 84.6). There were 425 lower limb and 32 upper limb frames. The mean duration of treatment was 25.7 weeks (1.6 to 85.3). According to NICE guidelines all the patients had at least one risk factor for VTE, 246 had two, 172 had three and 31 had four or more. One patient (0.23%) developed a pulmonary embolus after surgery and was later found to have an inherited thrombophilia. There were 27 deaths, all unrelated to VTE. The cost of providing VTE prophylaxis according to NICE guidelines in this group of patients would be £89 493.40 (£195.80 per patient) even if the cheapest recommended medication was used. The rate of symptomatic VTE after Ilizarov surgery was low despite using no pharmacological prophylaxis. This study leads us to question whether NICE guidelines are applicable to these patients. |
| first_indexed | 2024-03-07T01:37:34Z |
| format | Journal article |
| id | oxford-uuid:95baf3bb-3938-4e7a-8e0b-32d234f00f44 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:37:34Z |
| publishDate | 2014 |
| publisher | Journal of Bone and Joint Surgery Inc. |
| record_format | dspace |
| spelling | oxford-uuid:95baf3bb-3938-4e7a-8e0b-32d234f00f442022-03-26T23:48:08ZThe rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:95baf3bb-3938-4e7a-8e0b-32d234f00f44EnglishSymplectic Elements at OxfordJournal of Bone and Joint Surgery Inc.2014Ferguson, JSutherland, MPandit, HMcNally, MRecent recommendations by the National Institute for Health and Care Excellence (NICE) suggest that all patients undergoing elective orthopaedic surgery should be assessed for the risk of venous thromboembolism (VTE). Little is known about the incidence of symptomatic VTE after elective external fixation. We studied a consecutive series of adult patients who had undergone elective Ilizarov surgery without routine pharmacological prophylaxis to establish the incidence of symptomatic VTE. A review of a prospectively maintained database of consecutive patients who were treated between October 1998 and February 2011 identified 457 frames in 442 adults whose mean age was 42.6 years (16.0 to 84.6). There were 425 lower limb and 32 upper limb frames. The mean duration of treatment was 25.7 weeks (1.6 to 85.3). According to NICE guidelines all the patients had at least one risk factor for VTE, 246 had two, 172 had three and 31 had four or more. One patient (0.23%) developed a pulmonary embolus after surgery and was later found to have an inherited thrombophilia. There were 27 deaths, all unrelated to VTE. The cost of providing VTE prophylaxis according to NICE guidelines in this group of patients would be £89 493.40 (£195.80 per patient) even if the cheapest recommended medication was used. The rate of symptomatic VTE after Ilizarov surgery was low despite using no pharmacological prophylaxis. This study leads us to question whether NICE guidelines are applicable to these patients. |
| spellingShingle | Ferguson, J Sutherland, M Pandit, H McNally, M The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis. |
| title | The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis. |
| title_full | The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis. |
| title_fullStr | The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis. |
| title_full_unstemmed | The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis. |
| title_short | The rate of symptomatic venous thromboembolism in patients undergoing elective Ilizarov surgery and the cost of chemical prophylaxis. |
| title_sort | rate of symptomatic venous thromboembolism in patients undergoing elective ilizarov surgery and the cost of chemical prophylaxis |
| work_keys_str_mv | AT fergusonj therateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT sutherlandm therateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT pandith therateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT mcnallym therateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT fergusonj rateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT sutherlandm rateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT pandith rateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis AT mcnallym rateofsymptomaticvenousthromboembolisminpatientsundergoingelectiveilizarovsurgeryandthecostofchemicalprophylaxis |