Efficacy of Combined Modality Prophylaxis Including Short-Duration Warfarin to Prevent Venous Thromboembolism After Total Hip Arthroplasty

James A. Keeney, John C. Clohisy, Madelyn C. Curry, William J. Maloney

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

This study reviewed the effectiveness of a trimodality deep venous thrombosis (DVT) prophylactic regimen after primary and revision total hip arthroplasty. Seven hundred five patients were treated with pneumatic compression, adjusted dose warfarin (7 days), and early mobilization. Bilateral lower extremity venous ultrasonography was obtained on postoperative day 3 or 4. The incidence of asymptomatic DVT, symptomatic DVT/pulmonary embolus events within 90 days of surgery, and potential influence of risk factors was retrospectively assessed. Deep venous thrombosis incidence was 4.4% with one (0.1%) nonfatal pulmonary embolus. Increased age, male sex, and DVT history were significant risk factors for thromboembolic events within 90 days of hip arthroplasty. The combination of short-duration warfarin and mechanical prophylaxis with predischarge ultrasound screening was safe and effective in limiting the occurrence of venous thromboembolism.

Original languageEnglish
Pages (from-to)469-475
Number of pages7
JournalJournal of Arthroplasty
Volume21
Issue number4
DOIs
StatePublished - Jun 1 2006

Keywords

  • Coumadin
  • anticoagulation
  • deep vein thromboembolism
  • pulmonary embolism
  • total hip arthroplasty

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