Title

Practice patterns in the use of venous thromboembolism prophylaxis after total joint arthroplasty--insights from the Multinational Global Orthopaedic Registry (GLORY)

UMMS Affiliation

Center for Outcomes Reseaerch

Date

9-10-2010

Document Type

Article

Medical Subject Headings

Anticoagulants; *Arthroplasty, Replacement, Hip; *Arthroplasty, Replacement, Knee; Databases, Factual; Health Planning Guidelines; Heparin, Low-Molecular-Weight; Humans; Intermittent Pneumatic Compression Devices; *Physician's Practice Patterns; Postoperative Complications; *Registries; Venous Thromboembolism; Warfarin

Disciplines

Health Services Research

Abstract

The Global Orthopaedic Registry (GLORY) offers insights into multinational practice patterns of venous thromboembolism (VTE) prophylaxis in orthopedic surgery, based on data from 15,020 patients undergoing primary total knee arthroplasty or primary total hip arthroplasty from 2001 to 2004. Registry data show that the first choice for in-hospital VTE prophylaxis was low-molecular-weight heparin. Multimodal prophylaxis was common. Warfarin was more widely used in the USA than elsewhere in the world. GLORY data suggest that real-world practice often fails to meet the standards for prophylaxis recommended in the American College of Chest Physicians evidence-based guidelines, particularly in the USA. However, many US orthopedic surgeons may follow other practice guidelines, causing an underestimation of prophylaxis us in this study. Warfarin in the USA often failed to achieve recommended target International Normalized Ratio (INR) values. This paper reviews the GLORY practice findings in light of the contemporary literature on best practices for VTE prophylaxis in orthopedic patients.

Rights and Permissions

Citation: Am J Orthop (Belle Mead NJ). 2010 Sep;39(9 Suppl):14-21.

Related Resources

Link to Article in PubMed