No Effect of Prophylaxis Type on Pulmonary Embolism Rate

Prophylaxis agent, anesthesia type do not affect pulmonary embolism rate post hip arthroplasty

FRIDAY, Oct. 14 (HealthDay News) -- The rate of pulmonary embolism after total hip arthroplasty does not differ by the type of prophylaxis or anesthesia used, according to a study published in the Oct. 5 issue of The Journal of Bone & Joint Surgery.

Monti Khatod, M.D., from the Kaiser Permanente Baldwin Park in California, and colleagues investigated whether any prophylactic agent could better prevent postoperative pulmonary embolism, and whether the rate of pulmonary embolism was affected by the type of anesthesia used. Data for 17,595 patients without a history of venous thromboembolism who underwent unilateral total hip arthroplasty between 2001 and 2008 were analyzed. Multivariate regression analysis was used to assess the rates of pulmonary embolism, fatal pulmonary embolism, and death with respect to the prophylactic agent and anesthesia-type used.

The investigators found that the overall rate of pulmonary embolism was 0.41 percent. Pulmonary embolism rates for various prophylactic methods were: 0.37 percent for mechanical prophylaxis alone, 0.40 percent for low-molecular weight heparin, and 0.43 percent each for aspirin and Coumadin. Pulmonary embolism rates for general and non-general anesthesia were 0.43 and 0.40 percent, respectively. The overall mortality rate was 0.51 percent. Mortality rates were 0.67, 0.64, 0.51, 0.42 percent for mechanical prophylaxis, aspirin, Coumadin, and heparin, respectively. For general and non-general anesthesia, the mortality rates were 0.51 and 0.50 percent, respectively. After adjusting for age, gender, and American Society of Anesthesiologists score, the type of prophylaxis or anesthesia used did not show any correlation with increased pulmonary embolism risk.

"No differences in pulmonary embolism outcomes or death were detected across prophylactic groups and anesthesia types," the authors write.

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