A863. TIMING OF SYMPTOMATIC PULMONARY EMBOLI FOLLOWING TOTAL HIP AND TOTAL KNEE ARTHROPLASTY. ARE WE AIMING AT THE WRONG TARGET

摘要: The focus of deep vein thrombosis (DVT) prophylaxis following total joint arthroplasty has shifted in recent years to the reduction symptomatic pulmonary emboli (PE). relative infrequency and presumed delayed occurrence these events led many suggest that risks more frequent early postoperative complications treatment, especially bleeding, be weighed against benefits thromboembolic prophylaxis. purpose this study was determine timing risk factors associated with development PE hip (THA) knee (TKA). A retrospective analysis performed all patients diagnosed a embolism THA TKA from January, 2004 March, 2008. records 4706 were reviewed who operated upon by 7 surgeons, 58 identified. All managed treated an anti-coagulation dosing service. Helical CT Scans used make diagnosis PE. overall incidence 1.2%, 1.8% occurring TKAs 0.5% THAs. 48 (83%) women. 33 (57%) had unilateral TKA, 14 (24%) bilateral 11 (19%) THA. average patient age 65 (range: 44–88) BMI 33.8 24.7–51.9). There no apparent correlation between 4 days 1–46) surgery. 56 (97%) sixth day. INR at time 1.7 1.0–3.0). two mortalities (3%), both which occurred within first days. predominantly women undergoing TKA. appears urgent need develop effective program aimed preventing post-operative period identify