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. 2007 Jul;89(5):517-20.
doi: 10.1308/003588407X202065.

Post-discharge symptomatic thromboembolic events in hip fracture patients

Sanjeev Anand  1 , Keyur Buch
Affiliations

Post-discharge symptomatic thromboembolic events in hip fracture patients

Sanjeev Anand et al. Ann R Coll Surg Engl. 2007 Jul.

Abstract

Introduction: The aim of this study was to audit referral rates for post-discharge symptomatic thromboembolic events following hip fracture surgery to assess the extent of the clinical problem and to initiate discussion on prolonged chemoprophylaxis.

Patients and methods: All patients who underwent surgery for proximal hip fractures in one year (2001-2002) were followed up. Patient case-notes were used to identify all morbidity episodes within 3 months following discharge. Patients with suspected symptomatic thromboembolic episodes were investigated to confirm the diagnoses objectively. Reasons for hospital readmission and causes of death were identified.

Results: A total of 267 patients who underwent surgery for proximal hip fractures were included in the study. Forty-three patients died during initial admission episode. Of the 224 patients discharged, 46 (20.54%) patients were referred back to hospital within 3 months, for unplanned emergency management. Of these, 8 patients (3.57%) were referred back for suspected thromboembolic events. Of these, 6 (2.67%) were referred with a clinical diagnoses of deep vein thrombosis (DVT) but only 1 patient (0.45%) was confirmed to have DVT. Two patients (0.89%) were referred with features of pulmonary embolism (PE). Both were confirmed on ventilation-perfusion scans and both patients died. One patient died following PE in the community.Thus, overall, 3 deaths (1.34%) following discharge were recorded to be due to pulmonary embolism.

Conclusions: Suspected thromboembolic events constitute a major proportion of unplanned referrals back to the hospital. Three deaths due to delayed pulmonary embolism may justify prolonged universal chemoprophylaxis following hip fracture surgery.

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References

    1. Delia Valle CJ, Mirzabeigi E, Zuckerman JD, Koval KJ. Thromboembolic prophylaxis for patients with a fracture of the proximal femur. Am J Orthop. 2002;31:16–24. - PubMed
    1. Thromboembolic Risk Factors (THRIFT) Consensus group. Risk of and prophylaxis for venous thromboembolism in hospital patients. BMJ. 1992;305:567–74. - PMC - PubMed
    1. Eriksson BI, Lassen MR, the PENTasaccharide in HIp-FRActure Surgery Plus (PENTHIFRA Plus) Investigators Duration of prophylaxis against venous thromboembolism with fondaparinux after hip fracture surgery: a multicenter, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2003;163:1337–42. - PubMed
    1. Bergqvist D, Benoni G, Bjorgell O, Fredin H, Hedlundh U, Nicolas S, et al. Low-molecular-weight heparin (enoxaparin) as prophylaxis against venous thromboembolism after total hip replacement. N Engl J Med. 1996;335:696–700. - PubMed
    1. Comp PC, Spiro TE, Friedman RJ, Whitsett TL, Johnson GJ, Gardiner GA, Jr, et al. Prolonged enoxaparin therapy to prevent venous thromboembolism after primary hip or knee replacement. Enoxaparin Clinical Trial Group. J Bone Joint Surg Am. 2001;83:336–45. - PubMed