Extended Therapy for Blood Clot Prevention Yields Greater Benefits in Hip/Knee Surgery

Patients undergoing total knee replacement (TKR) or total hip replacement (THR) surgeries may experience better outcomes if they receive extended therapy for the prevention of thrombosis (blood clots). Researchers from the University of Ottawa, ON, and Ortho-McNeil Pharmaceutical found that 2,140 patients undergoing TKR or THR who received short-duration (≤14 days) thromboprophylaxis experienced three times as many venous thromboembolism events, two times as many DVT events, six times as many pulmonary embolism events, and four times more major bleeding events than the 1,055 patients who received extended-duration therapy (≥15 days). Data suggest that, in patients undergoing TKR or THR surgery, extended-duration therapy for the prevention of thrombosis is clinically beneficial.

High Incidence of VTE in Lung Transplant Recipients

Patients who have had a lung transplant may be at high risk for venous thromboembolism (VTE). Researchers from The Methodist Hospital and Baylor College of Medicine in Texas conducted a retrospective review on 52 lung transplant recipients. Patients were primarily men (71 percent) and Caucasian (56 percent), with a mean age of 56.3 years. The most common pretransplant diagnoses were pulmonary fibrosis (46 percent) and chronic obstructive pulmonary disease (29 percent). The overall incidence of patients developing a VTE was 19.2 percent (n=10). Four patients had a DVT alone, three patients had both a DVT and a pulmonary embolism, and three patients had a pulmonary embolism alone. Of the variables assessed, only a pretransplant diagnosis of pulmonary fibrosis was independently associated with VTE, while lack of DVT prophylaxis did not reach significance.

Blood Sugar at Hospital Admission May Predict Pulmonary Embolism Prognosis

Patients with high blood sugar who are admitted to the hospital for pulmonary embolism (PE) may experience worse outcomes than patients with lower blood sugar levels. Researchers from Portugal compared in-hospital mortality and other adverse outcomes in 135 patients admitted with acute PE. Of the patients, 92 had blood sugar levels less than 250 mg/dL (group A), while 20 patients had blood sugar levels more than 250 mg/dL (group B). Results of the analysis showed that patients in group B were nearly three times as likely to experience in-hospital mortality or other adverse outcome than patients in group B. Researchers conclude that blood sugar level at the time of admission holds prognostic value for patients with acute PE.

Sleep Apnea Associated With Blood Clots

Sleep disordered breathing (SDB), which includes sleep apnea, may be a significant risk factor for the formation of venous thromboembolism (VTE), a collective term for pulmonary embolism (PE) and deep vein thrombosis (DVT). Researchers from Marshall University in West Virginia reviewed data from nearly 2.5 million patients hospitalized with SDB, of which the incidence of PE was 24,953 (1.03 percent), DVT was 28,378 (1.17 percent), and VTE was 47,160 (1.94 percent). There were 1,464,485 (60 percent) men, and 969,638 (40 percent) women with SDB. The relative risk for VTE in all patients with SDB compared with those without SDB was 1.72. In a subgroup analysis, the relative risk for VTE in women with SDB compared with women without SDB was 2.11. Among patients older than 60 years, the relative risk was 1.28. Researchers conclude that SDB is a significant risk factor for VTE, particularly in women.

Source: Jennifer Stawarz
American College of Chest Physicians

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