PPAHS will be beginning a new #patientsafety campaign to develop practical solutions to help assess and prevent venous thromboembolism (VTE) in patients undergoing orthopedic procedures, particularly total knee and hip replacement. More commonly known as blood clots, VTE consists of both deep vein thrombosis (DVT) and pulmonary embolisms (PE) .
In the past, we have focused on the issue of VTE regarding maternal patients and stroke patients. In collaboration with panels of international health experts, PPAHS has developed the OB VTE Safety Recommendations and the Stroke VTE Safety Recommendations (both of which are free resources on our website). Members of the panel included:
- Atul Gawande, MD, MPH (Brigham and Women’s Hospital)
- Peter J. Pronovost, MD, PhD, FCCM (Johns Hopkins Medicine)
- Mark Alberts, MD, FAHA (Southwestern Medical Center)
- Irene Katzan, MD, MS (Cleveland Clinic)
- William M. Callaghan, MD, MPH (CDC)
- Frank Federico, RPh (Patient Safety Advisory Group, The Joint Commission)
- Mary D’Alton, MD (Columbia University Medical Center)
According to the CDC, VTE is estimated to affect 900,000 Americans annually. It is a preventable, hospital-acquired condition that is responsible for 100,000 deaths each year. The US Department of Health & Human Services (HHS) has also issued a statement identifying venous thromboembolism as the third most prevalent factor accounting for readmission 30-days after surgery (6.3%).
Hip and knee replacement operations are among the most commonly performed procedures in the U.S. About 1 million of these procedures are performed each year (for more on prevalence, see the study by Hilal Maradit-Kremers, MD, MSc et al, “Prevalence of Total Hip (THA) and Total Knee (TKA) Arthroplasty in the United States”). The 30-day readmission rate following hip and knee replacement is 4.3% and 3.9% respectively, with the readmission rate rising to 7.8% 90-days after surgery.
Join us in our fight to prevent orthopedic venous thromboembolism (VTE).
Over the next few months, we will be putting together an expert patient safety panel on orthopedic VTE to advise and help answer healthcare reporters’ questions, looking for interviewees for Patient Safety Podcasts (such as the series created in collaboration with the Society of Hospital Medicine), and for guest contributions to our blog.
Thanks for your work. One major site, Bonesmart, advises TKA folks to do almost nothing but rest, ice & elevate post-op. Yikes! And prophylaxis appears all over the place, from aspirin to Pradaxa.
Deep vein thrombosis can cause symptoms that include generalized swelling in the affected area. The area that is affected my measure larger than the unaffected area, and may also appear to be red and warm to the touch. Tenderness in the area can also be present, as well as pain when it is squeezed or touched, as well as when it moves or the patient becomes mobile.