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Inge Marshall, RN and Robert
G. Eubanks, MD
Between August and December of
2002, 12 patients were observed to have developed either PE
or DVT, or both. The ages ranged from 39 to 84 (8 females,
4 males). There were 9 orthopaedic surgeries (75%), one hysterectomy
(8%), one emergent abdominal surgery (8%), one cardiac surgery
(8%). Anesthesia varied with 8 generals, 3 spinals/epidurals
and one local anesthetic with moderate sedation. Risk factors
were noted to be obesity, cancer, smoking, estrogen use, cardiac
dysfunction and COPD. Postoperative mobilization was reviewed.
Preoperative, intraoperative and postoperative embolism prophylaxis
was also noted. There were found to be 9 PE (7 ortho, 1 TAH,
1 cardiac - pacemaker); 3 PE/DVT (2 ortho, 1 abdominal). The
treatment regimens and outcomes are noted. Eleven recovered
and were started on combination thrombolytics. One patient
expired. There were 5 readmissions.
The above focus review lead to
orthopaedic guidelines for PE/DVT in our hospital. It is recommended
that guidelines for the prevention of PE/DVT be part of the
working policy in our hospital.
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