Australia & New Zealand Society of Vascular Surgeons

Aim To assess the clinical incidence of venous thromboembolism (VTE) and utilisation of thromboprophylactic protocols in patients undergoing elective total hip arthroplasty (THA). Methods A retrospective review was performed on all patients admitted to Westmead Hospital over a 7 year period from 1996 to 2002. A proforma was developed which included information on demographics, mechanism of injury, VTE risk factors, prophylactic modalities (mechanical and pharmacological), operation duration, mode of anaesthesia, hospital length of stay (LOS) and post operative complications with particular attention to suspected deep vein thrombosis (DVT) and / or pulmonary embolism (PE). Results There were 268 patients with a female to male ratio of 1.4 to 1. Median age for females was 69.5 years and 66 years for males (p>0.05). Median hospital LOS was 8 days. The overall incidence of VTE was 2.6%. All patients received mechanical and / or pharmacological prophylaxis. Low molecular weight heparin usage remained high throughout the study period with a slight decrease after 2000. 25.2% of patients received spinal anaesthesia with no reported complications of spinal canal haematoma. Conclusion DVT can lead to PE that may be fatal and in the long term DVT can lead to post-thrombotic venous insufficiency impacting quality of life and health care costs. Our clinical incidence of VTE was found to be low and thromboprophylactic protocols were appropriately applied.