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Death rate from pulmonary embolism following joint replacement surgery
D Mcgrath1, W G Dennyson, M Rolland
1Department of Orthopaedic Surgery, Borders General Hospital, Melrose, Roxburghshire, UK.
Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1996
Summary
This study examined fatal pulmonary embolism after hip and knee replacements without routine anticoagulation. Six deaths occurred, questioning the necessity of routine prophylactic anticoagulation for these procedures.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Thrombotic Events
Background:
- Pulmonary embolism (PE) is a significant risk following major orthopedic surgery.
- Prophylactic anticoagulation is standard practice to mitigate PE risk.
- This study investigates outcomes in a center not routinely using anticoagulation.
Purpose of the Study:
- To determine the incidence of fatal pulmonary embolism after total hip and total knee replacement.
- To evaluate the necessity of routine prophylactic anticoagulation in this surgical context.
Main Methods:
- Retrospective study design.
- Analysis of 1569 patients undergoing total hip or total knee replacement.
- Review of mortality data specifically for fatal pulmonary embolism.
Main Results:
- A total of 1569 patients were included (1362 total hip replacements, 207 total knee replacements).
- Six cases of fatal pulmonary embolism were identified.
- The incidence of fatal PE was observed in the absence of routine prophylactic anticoagulation.
Conclusions:
- The incidence of fatal pulmonary embolism in this cohort warrants further investigation.
- The routine use of prophylactic anticoagulation following total hip and knee replacement is questioned based on these findings.