Pulmonary embolism after total joint arthroplasty: Cost and effectiveness of four treatment modalities

Ibrahim J. Raphael, James C. McKenzie, Benjamin Zmistowski, Daniel B. Brown, Javad Parvizi, Matthew S. Austin

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)933-937
Number of pages5
JournalJournal of Arthroplasty
Volume29
Issue number5
DOIs
StatePublished - May 2014
Externally publishedYes

Keywords

  • Anticoagulation
  • Hip
  • Inferior vena cava filter
  • Knee
  • Pulmonary embolus
  • Total joint arthroplasty

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