The changes in preferences for venous thromboembolism prophylaxis after total joint arthroplasty in Turkey: A survey
Nesrullah Azboy1, Oğuzhan Çimen2, Abdullah Demirtaş3, Serhat Elçi4, İbrahim Azboy5
1Department of Public Health, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
2Department of Orthopedics and Traumatology, İstanbul Medipol Hospital, İstanbul, Turkey
3Department of Orthopedics and Traumatology, Medeniyet University Faculty of Medicine, İstanbul, Turkey
4Department of Orthopedics and Traumatology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
5Department of Orthopedics and Traumatology, Medipol University Faculty of Medicine, İstanbul, Turkey
Keywords: Arthroplasty; prophylaxis; questionnaire; Turkey; venous thromboembolism.
Objectives: This study aims to investigate the changes in preferences of orthopedic surgeons for venous thromboembolism (VTE) prophylaxis after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and the factors that affect such changes in Turkey. Materials and methods: Turkish Orthopedics and Traumatology Association members (n=2,180) were invited to fill in the questionnaire. A total of 366 orthopedic surgeons responded and completed questionnaire. The questionnaire was comprised of 12 questions investigating the demographics of surgeons, their preferences for VTE prophylaxis, the changes in their preferences over the course of the past three years, and the causes of such changes.
Results: In the past three years, 31.1% of surgeons changed their VTE prophylaxis method and 32.7% used risk classifications. The use of low molecular weight heparin (LMWH) decreased from 89.4% to 42.5% and from 85.8% to 44.2% after TKA and THA, respectively. The use of aspirin increased from 10.6% to 43.4% and from 9.7% to 37.2% after TKA and THA, respectively. The use of oral anticoagulants increased from 11.5% to 41.6% and from 10.6% to 39.8% after TKA and THA, respectively. Still, orthopedic surgeons in Turkey preferred LMWH at rates of 75.7% and 74% after TKA and THA, respectively. Congressional presentations were the first (47.7%) among the causes of the changes in preferences for VTE prophylaxis. Preferences of up to 60% of surgeons working at universities were influenced by the American Academy of Orthopedic Surgeons guidelines.
Conclusion: In the past three years, approximately one third of orthopedic surgeons changed their preferences for VTE prophylaxis after total joint arthroplasty in Turkey. Changes in preferences were largely in favor of aspirin and oral anticoagulants in parallel to changes in guidelines for VTE prevention.