[Thrombosis prevention in orthopaedic surgery: clinical practice in the Netherlands in 2002]

Abstract

Objective: Establish the use of thromboprophylaxis in orthopaedic surgery both during and after the hospital admission.

Design: Cross-sectional study.

Method: In April 2002, a letter was sent to all orthopaedic surgeons in the Netherlands announcing that at every hospital with a Department of Orthopaedic Surgery, an orthopaedic surgeon would be approached for a telephone survey. They were phoned in the months April-June 2002. This study included hospitals where major orthopaedic surgery (e.g. the insertion of hip or knee prostheses and hip fracture surgery) took place (n = 124) as well as clinics that only performed day treatments (n = 5).

Results: For major orthopaedic operations, 91% of the hospitals used low molecular weight heparin (LMWH) during the admission period: 36% as monotherapy and 55% in combination with coumarin derivates. In 85% of cases the use of LMWH was started preoperatively. Coumarin derivates were used as a monotherapy in 9% of the hospitals. In 37% of the hospitals the use of NSAIDs was continued, particularly in patients with rheumatoid arthritis. In 94% of the hospitals, the use of acetylsalicylic acid was always stopped. In 97% of the hospitals prophylaxis was given after discharge in the form of LMWH (37% of the cases) or coumarin derivates (63% of the cases). The use of thromboprophylaxis with respect to arthroscopies and plaster immobilisation was variable.