Venous Thromboembolism Prevention Protocol: Experience of 2,000 Cases in Total Knee Arthroplasty*

Carvalho Júnior, Lúcio Honório de; Correa, Matheus de Almeida; Lima, Matheus Rezende; Silvestre, Camila Barreto; Almeida, Victor Ferreira; Temponi, Eduardo Frois

doi:10.1055/s-0039-1698798

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Sumário

Artigos Originais, Joelho • Rev. bras. ortop. 55 (4) • Jul-Aug 2020 • https://doi.org/10.1055/s-0039-1698798 copy

Venous Thromboembolism Prevention Protocol: Experience of 2,000 Cases in Total Knee Arthroplasty*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

The objective of the present study is to evaluate the impact evaluate the impact of an institutional protocol on a tertiary hospital for the prevention of venous thromboembolism in 2005 patients submitted to primary total knee arthroplasty (TKA).

Methods

Data from medical records of patients submitted TKA before (n = 1,115) and after (n = 890) the implementation of the institutional protocol, totaling 2,005 patients, were retrospectively reported. Demographics, comorbidities, and outcomes were analyzed.

Results

There was no significant change in the cases of deep venous thrombosis (DVT) (1.6% versus 2.4%; p = 0.211). There was an increase in cases of pulmonary embolism (PE) (0.2% versus 0.8% p = 0.049).

Conclusion

Despite the implementation of the prevention protocol, no reduction in the studied events was observed. The small global incidence makes further studies with larger series necessary to confirm or rule out these findings.

Keywords
thromboembolism/complications; arthroplasty, replacement, knee; risk factors

Condensed Table
Variable	Category	General (n = 2.0005)		Before 2014 (n = 1.115)		After 2015 (n = 890)
Variable	Category	N	%	N	%	N	%
Gender	Male	508	25,3	275	24,7	233	26,2
	Female	1,497	74,7	840	75,3	657	73,8
	Total	2,005	100,0	1115	100,0	890	100,0
VTE	Yes	9	0,4	2	0,2	7	0,8
	No	1,980	98,8	1112	99,7	868	97,5
	Not informed	16	0,8	1	0,1	15	1,7
	Total	2,005	100.0	1,115	100.0	890	100.0
DVT	Yes	39	1.9	18	1.6	21	2.4
	No	1,950	97.3	1,096	98.3	854	96.0
	Not informed	16	0.8	1	0.1	15	1.7
	Total	2,005	100.0	1,115	100.0	890	100.0
Anticoagulants use	Yes	1,364	68.0	492	44.1	872	98.0
	No	641	32.0	623	55.9	18	2.0
	Total	2,005	100.0	1,115	100.0	890	100.0
HBP	Yes	1,294	64.5	613	55.0	681	76.5
	No	598	29.8	393	35.2	205	23.0
	Not informed	113	5.6	109	9.8	4	0.4
	Total	2,005	100.0	1,115	100.0	890	100.0
DM	Yes	368	18.4	166	14.9	202	22.7
	No	1,636	81.6	949	85.1	687	77.2
	Not informed	1	0.0	0	0.0	1	0.1
	Total	2,005	100.0	1,115	100.0	890	100.0
Smoking	Yes	74	3.7	28	2.5	46	5.2
	No	1,931	96.3	1,087	97.5	844	94.8
	Total	2,005	100.0	1,115	100.0	890	100.0
VTE history	Yes	85	4.2	42	3.8	43	4.8
	No	1,918	95.7	1,073	96.2	845	94.9
	Not informed	2	0.1	0	0.0	2	0.2
	Total	2,005	100.0	1,115	100.0	890	100.0
Walking training	2 hour	2	0.1	2	0.2	0	0.0
	24 hour	1,648	82.2	954	85.6	694	78.0
	48 hour	316	15.8	141	12.6	175	19.7
	72 hour	32	1.6	14	1.3	18	2.0
	96 hour	4	0.2	1	0.1	3	0.3
	120 hour	3	0.1	3	0.3	0	0.0
	Total	2,005	100.0	1,115	100.0	890	100.0
ASA	I	100	5.0	14	1.3	86	9.7
	II	1,005	50.1	265	23.8	740	83.1
	III	70	3.5	11	1.0	59	6.6
	Not informed	830	41.4	825	74.0	5	0.6
	Total	2,005	100.0	1,115	100.0	890	100.0

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[1] Address for correspondence Eduardo Frois Temponi, MSc, Hospital Madre Teresa, Av. Raja Gabáglia 1002, Gutierrez, Belo Horizonte, Minas Gerais, 30430-142, Brazil (e-mail: dufrois@hotmail.com).