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Practice patterns in prophylaxis of deep vein thrombosis among US orthopedic surgeons
1Orthopedic Surgery Division, San Francisco General Hospital, Calif.
Insights
Thromboembolic disease is a major public health issue. While orthopedic surgeons widely use primary prophylaxis, a lack of secondary prevention may contribute to preventable deaths from pulmonary embolism.
Area of Science:
- Public Health
- Medical Research
- Clinical Practice
Background:
- Thromboembolic disease, including pulmonary embolism, is a significant cause of mortality.
- An estimated 200,000 deaths occur annually in the US due to pulmonary embolism.
- A substantial proportion of these deaths, around 100,000, are considered preventable.
Purpose of the Study:
- To investigate the practices of orthopedic surgeons regarding thromboembolic disease prevention.
- To identify potential reasons for the high mortality rates associated with pulmonary embolism.
Main Methods:
- The study likely involved a survey or analysis of clinical practices among orthopedic surgeons.
- Focus was placed on the adoption rates of primary prophylaxis versus secondary prevention strategies.
Main Results:
- Primary prophylaxis for thromboembolic disease is nearly universally practiced by orthopedic surgeons.
- Secondary prevention strategies are implemented by a significantly smaller proportion of orthopedic surgeons.
Conclusions:
- The widespread use of primary prophylaxis is positive, but insufficient.
- The low adoption of secondary prevention may be a key factor contributing to preventable deaths from thromboembolic disease.
- Increased implementation of secondary prevention is crucial to reduce mortality from pulmonary embolism.
Abstract:
Thromboembolic disease meets all the criteria of a major public health problem. Some studies have estimated that up to 200,000 Americans die each year as a result of pulmonary embolism. Furthermore, at least 50% of these people had an otherwise very good prognosis and should not have died. Thus, about 100,000 deaths from pulmonary embolism are preventable. This study indicates that, while primary prophylaxis is almost universal among orthopedic surgeons, very few practice secondary prevention, which could be the reason for the large number of deaths attributed to thromboembolic disease.