Patient Safety- Clinical

Efficacy in Deep Vein Thrombosis Prevention with Extended Mechanical Compression Device Therapy and Prophylaxis Aspirin Following Total Knee Arthroplasty.

The DVT rate for the post-discharge protocol of Aspirin and Portable Mechanical Compression therapy group was 0%. The DVT rate for the post-discharge protocol of just Aspirin group was 23.1%

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh

Antithrombotic Therapy and
Prevention of Thrombosis

In patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), we recommend use of one of the following for a minimum of 10 to 14 days rather than no antithrombotic prophylaxis: low-molecular-weight heparin (LMWH), fondaparinux, apixaban, dabigatran, rivaroxaban, low-dose unfractionated heparin (LDUH), adjusted-dose vitamin K antagonist (VKA), aspirin (all Grade 1B), or an intermittent pneumatic compression device (IPCD) (Grade 1C).

 

Remarks: We recommend the use of only portable, battery-powered devices capable of recording and reporting proper wear time on a daily basis for inpatients and outpatients. One panel member believed strongly that aspirin alone should not be included as an option.

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh

AAOS Guidelines

Recommendation 5

We suggest the use of pharmacologic agents and/or mechanical compressive devices for the prevention of venous thromboembolic disease in patients undergoing elective hip or knee arthroplasty, and who are not at elevated risk beyond that of the surgery itself for venous thromboembolism or bleeding.

 

Grade of Recommendation: Moderate

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh

Thrombosis Prevention after Total Hip
Arthroplasty

A Prospective Randomized Trial Comparing a Mobile Compression Device with Low Molecular Weight Heparin.

 

Results: There was no statistical difference between the groups in the incidence of VTE. Portable sequential devices did show a significant decrease in major bleeding events versus enoxaparin.

 

Interpretation: If Circul8 can prevent blood clots just as much as a pharmacologic option without the risks of a major bleeding event, the standard hospital protocol should be a baby aspirin and Circul8.

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh

National Patient Safety Goal
Addresses Direct Oral Anticoagulan

The prevention of adverse drug events (ADEs) is an important patient safety priority. We’ve learned that anticoagulants are among the most common medications causing adverse drug events. According to the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, ADEs account for an estimated one-third of hospital adverse events and approximately 280,000 hospital admissions annually.

Authors: Seung-Beom Han, MD, PhDa, Yong In, MD, PhDb, Kwang Jun Oh