Copyright (c) 2013 University of Massachusetts Medical School All rights reserved. http://escholarship.umassmed.edu/cor_other Recent documents in Other Center for Outcomes Research Publications en-us Wed, 13 Feb 2013 16:14:13 PST 3600 http://escholarship.umassmed.edu/cor_other/2 http://escholarship.umassmed.edu/cor_other/2 Mon, 24 Sep 2012 13:15:12 PDT A survey was mailed to a representative sample of US orthopedic surgeons to assess protocols for the prevention of venous thromboembolism after lower extremity total joint arthroplasty. Practices were examined by type of operation, annual surgical volume, and opinions of consensus guidelines issued by the American Academy of Orthopaedic Surgeons and the American College of Chest Physicians. Although there was near-unanimous agreement that routine thromboprophylaxis should be the standard practice for patients who undergo hip or knee arthroplasty, surgeons were divided as to the exact management approach.

]]> Frederick A. Anderson Jr. et al. Venous Thromboembolism Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee http://escholarship.umassmed.edu/cor_other/1 http://escholarship.umassmed.edu/cor_other/1 Tue, 07 Aug 2012 06:46:08 PDT Venous thromboembolism (VTE) prophylaxis is suboptimal in American hospitals despite long-standing evidence-based recommendations. Data from observational studies indicate a lower uptake of effective prophylaxis in patients hospitalized with medical versus surgical conditions. Reluctance to use prophylaxis in medical patients has been attributed to difficulty in identifying at-risk patients and balancing risks of bleeding against occurrence of VTE. Several risk-assessment models (RAMs) have been proposed to assist physicians in identifying non-surgical patients who need prophylaxis. We conducted a systematic review of published RAMs, based on objective criteria, to determine whether any RAM is validated sufficiently to be employed in clinical practice. We identified 11 RAMs, six derived from primary data and five based on expert opinion. The number, types, and strength of association of VTE risk predictors were highly variable. The variability in methods and outcome measurement precluded pooled estimates of these different models. Published RAMs for VTE lack generalizability and adequate validation. As electronic health records become more ubiquitous, validated dynamic RAMs are needed to assess VTE risk at the point-of-care in real time.

]]> Wei Huang et al. Venous Thromboembolism Risk Assessment