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Fatal pulmonary embolism after total hip replacement.

H O Fredin, A S Nillius

    Acta Orthopaedica Scandinavica
    |June 1, 1982
    PubMed
    Summary

    Fatal pulmonary embolism (FPE) occurred in 0.7% of total hip replacement (THR) patients. Premonitory chest pain and prior orthopedic surgery were significant risk factors for FPE.

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    Area of Science:

    • Orthopedic Surgery
    • Cardiovascular Surgery
    • Thromboembolic Disease

    Background:

    • Total hip replacement (THR) is associated with a risk of fatal pulmonary embolism (FPE).
    • Thromboembolic prophylaxis is crucial in patients undergoing THR.

    Purpose of the Study:

    • To determine the incidence of FPE after THR.
    • To identify risk factors associated with FPE in THR patients.

    Main Methods:

    • Retrospective analysis of 1,324 THR cases from 1969-1978.
    • Review of autopsy findings for patients who died within 3 months post-THR.
    • Comparison of clinical data between FPE patients and a control group.

    Main Results:

    • The incidence of FPE was 0.7% (9 out of 1,324 cases).
    • Premonitory acute chest pain (P < 0.001) and previous orthopedic operations (P < 0.05) were significantly more common in FPE patients.
    • Heparin therapy did not prevent FPE in four cases.

    Conclusions:

    • FPE remains a significant risk following THR.
    • Early recognition of chest pain and a history of orthopedic surgery may indicate increased FPE risk.
    • Further research into effective FPE prophylaxis is warranted.

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