Analysis of venous thromboprophylaxis duration and outcomes in orthopedic patients.

Abstract Venous thromboembolism (VTE) following total hip replacement (THR) and total knee replacement (TKR) surgery imposes significant health and economic burden. To examine the impact of thromboprophylaxis duration on deep vein thrombosis (DVT), pulmonary embolism (PE), total VTE (DVT and PE), and bleeding events among THR/TKR patients. A retrospective study (April 1, 2004, to December 31, 2006) was conducted using a US health plan claims database linked to an inpatient database containing medication use. Outcomes were compared using χ2 tests; predictors of outcomes were analyzed using multivariate logistic regression. Of 3497 patients, 3195 (91%) received thromboprophylaxis for =1 day postsurgery. Most patients (67%) received short-duration (1-14 days) rather than extended-duration (>14 days) thromboprophylaxis. The incidence of thromboembolic and bleeding events was higher in those who received short-duration thromboprophylaxis: DVT (2.84% vs 1.24%; P = .0038), PE (1.12% vs 0.19%; P = .0052), total VTE (3.96% vs 1.43%; P