DOI: 10.1097/01.ruq.0000263823.11380.24
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Issn Print: 0894-8771
Publication Date: 2007/03/01
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Excerpt
This study evaluated 2 ultrasound protocols for screening for deep venous thrombosis following total hip and total knee replacement operations: the first involved screening ultrasound examinations performed at the time of hospital discharge (n = 931) and the second involved ultrasound screening performed 2 weeks after the index surgery, with patients receiving warfarin anticoagulation therapy during this period (n = 1433).
Standard compression ultrasonography was performed, imaging the deep veins of the lower extremities inclusive of the anterior and posterior tibial venous systems.
A prevalence rate of 2.5% of deep venous thrombosis was found in the group undergoing ultrasound examination before discharge and a prevalence of 2.2% for those undergoing screening 2 weeks after the surgery. There were 3 clinically relevant pulmonary emboli in each cohort group, none of which had a positive ultrasound examination. In addition, complications of anticoagulation prophylaxis such as gastrointestinal bleeding were observed with equal frequency in both cohorts.
Based on the results of this study, the authors have modified their ultrasound screening protocol after total hip or knee replacement to include 2 weeks of warfarin anticoagulation therapy with follow-up screening ultrasonography at 2 weeks after discharge in lieu of screening ultrasonography before discharge.
