Effect of intermittent pneumatic compression prophylaxis of venous thromboembolism in hip and knee surgery
Keywords:
intermittent pneumatic compression, venous thromboembolism, prophylaxisAbstract
Venous thromboembolism (VTE) is a serious problem in orthopedic surgery, especially hip and knee surgery. It was shown in recent study that VTE has a high mortality rate1. Standard VTE prophylaxis were chemical and mechanical, but were still concerned about bleeding during and after surgery. This caused a lack of proper chemical use. The benefit of mechanical prophylaxis alone is still questioned. However, the intermittent pneumatic compression device (IPC) is another choice for VTE mechanical prophylaxis. Moreover, this study covered incidence, demographic data, underlying disease and the length of hospital stay between two groups. The retrospective cohort study was processed in Samutprakarn General Hospital from 1st January 2021 to 31st December 2022. All of the data were collected from medical records and the human research ethics was issued by a government agency. Then, purposive sampling was applied with an inclusion and exclusion criteria and was classified into two groups, the first group used a new VTE prophylaxis protocol with an IPC device and the second group used a standard VTE prophylaxis protocol. The statistical analysis employed descriptive statistics and invariable analysis with Pearson’s Chi-Square and Fisher’s Exact test, and multivariable analysis with an independent t-test. Duplex Doppler ultrasonography in DVT or CT-angiography in PE was used for confirmation diagnosis. After analysis, the results showed that the VTE incidence in the new VTE prophylaxis protocol group (0.67%) was lower than standard VTE prophylaxis protocol (5.70%) with a statistical difference. The demographic data, underlying disease, and length of hospital stay had no statistical difference (p>0.05). In contrast, for body mass index (BMI), the experimental group was higher than the control group (p<0.05). In conclusion, the new VTE prophylaxis protocol can decrease incidence of VTE at a lower level than the standard group.
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