TY - JOUR
T1 - Pulmonary embolism after total joint arthroplasty
T2 - Cost and effectiveness of four treatment modalities
AU - Raphael, Ibrahim J.
AU - McKenzie, James C.
AU - Zmistowski, Benjamin
AU - Brown, Daniel B.
AU - Parvizi, Javad
AU - Austin, Matthew S.
PY - 2014/5
Y1 - 2014/5
N2 - Pulmonary embolism (PE) treatment relies on therapeutic anticoagulation and may be associated with severe complications. Inferior vena cava filters (IVCFs) are used as an alternative/adjunct to anticoagulation. In this study we evaluate 4 treatment protocols for clinical efficacy and cost. We reviewed over 27,000 total joint arthroplasty (TJA) patients. We retrospectively identified 294 patients with a documented, symptomatic PE within 90. days of surgery. All patients were treated with warfarin postoperatively. In addition, for the acute management, patients were divided into four treatment groups: (1) IVCF only, (2) IVCF with heparin, (3) heparin only and (4) no treatment. Complication rates, hospital stay and PE recurrence are reported. Among patients who received warfarin, IVCF was associated with fewer complications and lower overall hospital costs compared to the use of heparin for the treatment of PE after TJA.
AB - Pulmonary embolism (PE) treatment relies on therapeutic anticoagulation and may be associated with severe complications. Inferior vena cava filters (IVCFs) are used as an alternative/adjunct to anticoagulation. In this study we evaluate 4 treatment protocols for clinical efficacy and cost. We reviewed over 27,000 total joint arthroplasty (TJA) patients. We retrospectively identified 294 patients with a documented, symptomatic PE within 90. days of surgery. All patients were treated with warfarin postoperatively. In addition, for the acute management, patients were divided into four treatment groups: (1) IVCF only, (2) IVCF with heparin, (3) heparin only and (4) no treatment. Complication rates, hospital stay and PE recurrence are reported. Among patients who received warfarin, IVCF was associated with fewer complications and lower overall hospital costs compared to the use of heparin for the treatment of PE after TJA.
KW - Anticoagulation
KW - Hip
KW - Inferior vena cava filter
KW - Knee
KW - Pulmonary embolus
KW - Total joint arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84899092752&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2013.09.033
DO - 10.1016/j.arth.2013.09.033
M3 - Article
C2 - 24269095
AN - SCOPUS:84899092752
SN - 0883-5403
VL - 29
SP - 933
EP - 937
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 5
ER -