SUGGESTED VENOUS THROMBOEMBOLISM (VTE) RISK STRATIFICATION SHEET FOR ORTHOPEDIC SURGERIES

Background: Major orthopedic surgeries are divided into 3 major surgeries: total or partial hip replacement (TPHR), total knee replacement (TKR), and hip fracture surgeries (HFS), these surgeries are considered as high-risk surgeries for the development of venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). In general there are several factors that increase the VTE risk post these surgeries, this study was carried out to figure out the effect of the following factors on the VTE rate post these surgeries: age, gender, type of anesthesia, admission days before surgery, duration of hospital stay, duration of surgery, co-morbidities, the presence of any other VTE risk factors and the type of orthopedic surgery, at Jordan University Hospital (JUH). Methods: This was a prospective observational study; it was carried out at JUH. One hundred and seventy patients were enrolled in the study. A follow-up period up to 35 days was used starting from the surgery date. As extended VTE prophylaxis, 31.8% (54/170) of patients have prescribed Enoxaparin 40 mg daily, while 68.2% (116/170) were prescribed aspirin 325 mg daily. Results: In the Jordanian population, the incidence of symptomatic VTE after major orthopedic surgery was high (8.82%). The highest VTE risk was seen in HFS (P-value of 0.05 for PE, and a P-value of 0.001 for DVT). Factors that associated positively with VTE events are age, type of anesthesia, admission days before surgery, duration of hospital stay, co-morbidities and the presence of any other VTE risk factors. Discussion: It should be indicated that this suggested risk stratification sheet for orthopedic surgeries needs validation to prove its effectiveness, and this, in turn, needs another future study. Conclusion: VTE incidence rate in Jordanian population is high due to the known contributing factors; thus modification in the procedure used should be applied to reduce this high VTE incidence rate. So the author suggested risk stratification sheet according to the positive associations shown in this study.