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Thromboprophylaxis After Major Orthopaedic Surgery: State of the Art

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European Instructional Lectures

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is estimated to affect over one million people in the EU each year. With over 540,000 VTE-related deaths estimated per year in Europe, VTE represents a signifi cant health concern. A study carried out in six European countries (France, Germany, Italy, Spain, Sweden and the UK) estimated the occurrence of over 460,000 cases of DVT and nearly 300,000 cases of non-fatal PE each year [1]. Two large community-based studies carried out in France and Sweden estimated the incidence of VTE to be approximately 160–180 per 100,000 population [2, 3]. Although slightly lower incidences have been reported in the United States [4, 5], it remains the third leading cause of cardiovascular death after myocardial infarction and stroke [6]. An estimated two million patients develop DVT each year in the United States and an estimated 600,000 develop PE, 10% of which are fatal [7].

As well as the short-term consequences, VTE is also associated with longer-term consequences such as recurrent events and the post-thrombotic syndrome (PTS). A prospective cohort study assessing the clinical course of 528 patients with symptomatic DVT in Italy found that nearly one-fi fth of patients experienced a recurrent event. The cumulative incidence of recurrent VTE after 2, 5 and 8 years was 17.2, 24.3 and 29.7%, respectively, and the cumulative incidence of PTS after 2, 5 and 8 years was 24.5, 29.6 and 29.8%, respectively [8]. Similar rates of the PTS have been reported in patients with venographically detected VTE in the postoperative period [9].

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  1. McMaster University, 237 Barton Street East, Hamilton, OH, L8L 2X2, Canada

    Alexander G. G. Turpie

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  1. Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, HA 7 4LP, UK

    George Bentley

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Turpie, A.G.G. (2009). Thromboprophylaxis After Major Orthopaedic Surgery: State of the Art. In: Bentley, G. (eds) European Instructional Lectures. European Federation of National Associations of Orthopaedics and Traumatology, vol 9. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-00966-2_4

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