Thromboprophylaxis Rate Low for Knee Arthroplasty in Taiwan

Prophylaxis rate of 2.2 percent may be related to low incidence of post-op venous thromboembolism

FRIDAY, Jan. 13 (HealthDay News) -- Pharmacologic thromboprophylaxis for Taiwanese patients undergoing total knee arthroplasty (TKA) is very low, at 2.2 percent, which may correlate with the low incidence of post-surgery venous thromboembolism (VTE), according to a study published in the January issue of the Journal of Thrombosis and Haemostasis.

C.H. Lee, of the National Cheng Kung University in Tainan, Taiwan, and colleagues conducted a population-based observational study to estimate the use of thromboprophylaxis and to calculate the incidence and risk factors of VTE in 113,844 patients in Taiwan who underwent TKA procedures from 1998 to 2007.

The investigators found that the overall rate of pharmacological thromboprophylaxis was 2.2 percent. There was a 0.46 percent three-month cumulative incidence of surgery-related symptomatic VTE. A total of 85.4 percent of all post-surgery VTE events occurred within two weeks of discharge, with a median time to first VTE event of seven days. Independent risk factors for the development of symptomatic VTE in this patient population included previous VTE, malignancy, heart failure, and neurologic disorder with extremity paralysis or paresis.

"The rate of pharmacological thromboprophylaxis is very low in Taiwan, which may be related to the low incidence of symptomatic VTE after major knee arthroplasties," the authors write. "Although universal pharmacological thromboprophylaxis is not recommended generally in Taiwan, it should be considered in high-risk populations."

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