Journal of Bone and Joint Surgery Publishes Recommendations to Establish Best Practice for Venous Thromboembolism (VTE) Prophylaxis in Orthopedics
DUBLIN, Ohio, March 22, 2022 /PRNewswire/ -- The Journal of Bone and Joint Surgery published an International Consensus Statement (ICS) with recommendations on Venous Thromboembolism (VTE) – the result of a year-long process supported by a grant from Cardinal Health and led by Dr. Javad Parvizi, MD, orthopedic surgeon and director of Clinical Research at the Rothman Orthopaedic Institute.
According to the National Institute of Health, VTE – otherwise known as blood clots in the veins – is "a common complication during and after hospitalization for medical and surgical patients. More than half of all hospitalized patients are at risk for VTE." VTE presents a serious, but often preventable problem for patients in the hospital. VTE associated with hospitalization was the leading cause of disability adjusted life-years lost in low-income and middle-income countries, and the second most common cause in high-income countries.1
With a shared mission to standardize treatment guidelines and decrease the occurrence of this complication worldwide, 600 experts from various specialties, including anesthesia, cardiology, hematology, internal medicine, and orthopedics, representing 68 countries and 135 international societies, met to review all published literature related to VTE and orthopedics, and develop the recommendations for VTE prophylaxis in orthopedic surgery; these recommendations were published together as an ICS.
Many organizations globally, including the American Academy of Orthopedic Surgeons and the American College of Chest Physicians, have created guidelines related to the issue of VTE in orthopedics. However, this is the first time an ICS toward prevention of VTE in orthopedic procedures has been published.
"Cardinal Health's investment in the ICS process underscores our commitment to the healthcare providers we serve and the patients who depend on them," said Kelley Moffett, senior vice president of Global Products at Cardinal Health. "The recommendations of the new guidelines will have applicability to patients across the globe undergoing various orthopedic procedures and the findings help us focus on clinical solutions that best serve clinicians and their patients. We thank Dr. Parvizi for his leadership and are proud to be a part of this important work involving clinicians around the globe – it's work that will help save lives."
According to Dr. Parvizi, the recommendations established in the ICS will improve patient care by reducing mortality, complications, and the subsequent episode of care costs.
"The ICS revealed there is little to no best practice evidence related to VTE following the majority of orthopedic procedures and the nature of these surgical procedures has changed over the years – now with an emphasis on early mobilization of the patients and less invasive surgical and anesthesia techniques," said Dr. Parvizi.
The findings produced by this initiative were driven by 200 questions, or subject matters, which included various surgical subspecialities in orthopedics. Important clinical information that will improve patient care were published in these various categories. Key highlights include:
- Mechanical compressive devices can be used routinely in patients undergoing total hip arthroplasty or total knee arthroplasty as VTE prophylaxis.
- For the majority of surgical procedures, it appears that aspirin and intermittent pneumatic compression devices, may be adequate.
- Development of VTE is influenced by genetic and other patient-specific predispositions. Recognizing these factors may help tailor the VTE prophylaxis accordingly.
- Currently, the industry lacks a validated and appropriate risk stratification system for VTE or bleeding; the medical community desperately needs those measures and stratification systems.
"Before Dr. Parvizi and experts from around the world undertook this work, there were numerous and conflicting compression therapy guidelines from well-respected, global organizations," said Alex Veloz, global manager of Scientific Communications at Cardinal Health. "These inconsistencies made it challenging for clinicians to determine the best approach to VTE prophylaxis for orthopedic surgical patients. The recommendations noted in the ICS represent a step forward in VTE prevention."
Stop by booth #4628 at the 2022 Annual Meeting of the American Academy of Orthopaedic Surgeons this week in Chicago or learn more about compression therapy on cardinalhealth.com.
- ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to the global disease burden. J Thromb Haemost 2014; 12: 1580–90.