Pulmonary Embolism After Total Joint Arthroplasty: Cost and Effectiveness of Four Treatment Modalities

Raphael I. J., McKenzie J. C., Zmistowski B., Brown D. B., Parvizi J., Austin M. S.

JOURNAL OF ARTHROPLASTY, cilt.29, sa.5, ss.933-937, 2014 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 5
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1016/j.arth.2013.09.033
  • Dergi Adı: JOURNAL OF ARTHROPLASTY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.933-937
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

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. (C) 2014 Elsevier Inc. All rights reserved.