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Low Risk of Thromboembolism Found in Podiatric Surgery

But practitioners should consider prophylactic treatment if patient has certain risk factors

MONDAY, April 13 (HealthDay News) -- Venous thromboembolism presents a low risk in podiatric surgery, but practitioners should consider prophylactic treatment if the patient has at least two risk factors, according to a study reported in the April issue of the journal Chest.

Andrew H. Felcher, M.D., of Northwest Permanente Medical Group in Portland, Ore., and colleagues collected electronic medical records for a 485,000-plus-member HMO in the Pacific Northwest and conducted an analysis of 7,264 patients who had 16,804 podiatric surgeries between 1999 and 2004.

The researchers identified 22 instances of post-operative venous thromboembolism for an incidence rate of 0.30 percent. In the podiatric setting, the three leading risk factors associated with venous thromboembolism were: previous venous thromboembolism (4.6 percent incidence), hormone replacement therapy or oral contraceptive use (0.55 percent incidence) and obesity (0.48 percent incidence).

"We identified a low overall risk of venous thromboembolism in podiatric surgery, suggesting that routine prophylaxis is not warranted. However, for patients with a history of venous thromboembolism, periprocedure prophylaxis is suggested based on the level of risk. For podiatry surgery patients with two or more risk factors for venous thromboembolism, periprocedure prophylaxis should be considered," the authors write. "Our study has a number of limitations…while not limiting the conclusions of our study, we would have liked to include non-weight-bearing status, immobility, and severity of illness in our risk factor analysis, but we could not reliably identify these risk factors in our database."

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