Pharmacologic Prophylaxis for Venous Thromboembolism Among Patients With Total Joint Replacement

An Electronic Medical Records Study

Marc Rosenman, Xianchen Liu, Hemant Phatak, Rong Qi, Evgenia Teal, Daniel Nisi, Larry Z. Liu, J. Parr

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Patients who have total hip (THR) or knee (TKR) replacement have an elevated risk of venous thromboembolism (VTE). The American College of Chest Physicians guidelines recommend prophylactic anticoagulation. The aim of the study was to examine pharmacologic prophylaxis against VTE among patients with THR or TKR and to assess demographic and clinical correlates related to VTE prophylaxis. Using 15 years of data (1995–2009) from an electronic medical record system for an inner-city public hospital in the United States, we examined pharmacologic prophylaxis against VTE and associated factors in patients after THR (n = 242) and TKR (n = 317). Before the early 2000s, aspirin was the most common prophylaxis agent (THR, 61% and TKR, 65%), and 26% of patients with THR and 19% of patients with TKR did not receive prophylaxis. Enoxaparin use has increased since 2000, and warfarin is now the most common prophylaxis agent (THR, 70% and TKR, 61%). After controlling for time period, factors associated with prophylaxis pattern included obesity, hip fracture, and the surgeonʼs number of years in practice. VTE prophylaxis medications in patients with total joint replacement have changed over 15 years, in trends generally consistent with the evolution of guidelines. Obesity, history of hip fracture, and physicianʼs experience are associated with the prescription of VTE prophylaxis medications.

Original languageEnglish (US)
JournalAmerican Journal of Therapeutics
DOIs
StateAccepted/In press - Dec 30 2015

Fingerprint

Replacement Arthroplasties
Electronic Health Records
Venous Thromboembolism
Hip Fractures
Obesity
Guidelines
Enoxaparin
Public Hospitals
Urban Hospitals
Warfarin
Aspirin
Prescriptions
Hip
Knee
Demography
Physicians

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Pharmacologic Prophylaxis for Venous Thromboembolism Among Patients With Total Joint Replacement : An Electronic Medical Records Study. / Rosenman, Marc; Liu, Xianchen; Phatak, Hemant; Qi, Rong; Teal, Evgenia; Nisi, Daniel; Liu, Larry Z.; Parr, J.

In: American Journal of Therapeutics, 30.12.2015.

Research output: Contribution to journalArticle

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