Preoperative Identification of Patients at High Risk of Deep Venous Thrombosis Despite Prophylaxis in Total Hip Replacement

E Rocha; M J Alfaro; J A Páramo; J M Cañadell

doi:10.1055/s-0038-1646772

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1988; 59(01): 093-095
DOI: 10.1055/s-0038-1646772

Review Article

Schattauer GmbH Stuttgart

Preoperative Identification of Patients at High Risk of Deep Venous Thrombosis Despite Prophylaxis in Total Hip Replacement

E Rocha

^*The Hematology Service and Orthopedic Surgery Department, University Clinic, University of Navarra, Pamplona, Spain

,

M J Alfaro

^*The Hematology Service and Orthopedic Surgery Department, University Clinic, University of Navarra, Pamplona, Spain

,

J A Páramo

^*The Hematology Service and Orthopedic Surgery Department, University Clinic, University of Navarra, Pamplona, Spain

,

J M Cañadell

^*The Hematology Service and Orthopedic Surgery Department, University Clinic, University of Navarra, Pamplona, Spain

› Author Affiliations

Abstract

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Summary

Clinical and laboratory variables were measured on the day before operation in 111 patients who underwent total hip replacement prophylactically treated with acetylsalicilic acid or heparin-dihydroergotamine. Postoperative deep vein thrombosis (DVT) was deteced in 16 patients by ascending venography. Stepwise logistic discriminant analysis was used to identify DVT predicting factors. Three such factors, fibrinogen degradation products (FDP), plasminogen activator inhibitor (PA-inhibitor) and tissue type plasminogen activator (t-PA), were found to be significantly associated with DVT and were used to construct a predictive index. The predictive index, I = —2.09 + 0.46 (FDP) +1.39 (PA-inhibitor)-0.24 (t-PA), was 100% sensitive and 95% specific in the prediction of DVT. This index would allow for identification of those patients in whom routine prophylaxis would be sufficient and for selecting those in whom more effective prophylactic regimens would be necessary.

Key words

Predictive index - Deep vein thrombosis - Total hip replacement - Surgery

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References

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