CORR Insights^®: Symptomatic Pulmonary Embolus After Joint Arthroplasty: Stratification of Risk Factors

Excerpt

Choosing the most appropriate treatment to minimize potential harm, along with evaluating the risk-benefit ratios of treatments we use, remain key issues in daily practice for healthcare practitioners. This is particularly true when using prophylaxis to prevent postoperative symptomatic venous thromboembolism in patients undergoing major orthopaedic surgery. The observed decreases in postoperative symptomatic venous thromboembolism risk are related to the development of effective prophylactic approaches. For patients undergoing major orthopaedic surgery, the cumulative occurrence rates of postoperative symptomatic venous thromboembolism measured up to 35 days postsurgery have decreased from 4.3% without prophylaxis (1.5% for pulmonary embolism and 2.8% for deep vein thrombosis) to 1.8% in patients receiving low-molecular weight-heparin [3] (0.55% for pulmonary embolism and 1.25% for deep vein thrombosis). However, these treatments can cause clinically important complications, such as bleeding, hematoma, infections [3, 6, 9]. Consequently, the study by Parvizi and colleagues examines ways to minimize the risk-benefit ratio among a subgroup of patients with potentially low-risk of venous thromboembolism. …