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The use of warfarin as thromboprophylaxis for lower limb arthroplasty
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Dunbar, Mark Robert, Upadhyay, Piyush K and Karthikeyan, Shanmugam (2008) The use of warfarin as thromboprophylaxis for lower limb arthroplasty. Annals of The Royal College of Surgeons of England, Vol.90 (No.6). pp. 500-503. doi:10.1308/003588408X300957 ISSN 0035-8843.
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Official URL: http://dx.doi.org/10.1308/003588408X300957
Abstract
INTRODUCTION: Most orthopaedic surgeons in the UK use some form of prophylaxis against venous thromboembolic events. Warfarin has been recommended as one of the preferred methods to use. The period of in-hospital postoperative rehabilitation has reduced significantly since lower limb arthroplasty was introduced. We sought to identify and quantify any delay in discharge associated in using warfarin as chemical prophylaxis.
PATIENTS AND METHODS: During a 12-week period, all patients undergoing a lower limb arthroplasty procedure were identified and any delay in discharge related to their warfarin prophylaxis was recorded.
RESULTS: Of the 25 arthroplasties performed in this time period, 17 (68%) were subject to a delay. The total delay in discharge was 39 days. When the standard warfarin dosing protocol was followed, 33% of patients were still delayed. When the protocol was not followed, only 23% were delayed. The majority of deviations from the protocol led to a shorter hospital stay.
DISCUSSION: Patients using warfarin prophylaxis generate an additional cost of £417 related to bed occupancy. There is considerable scope for significantly reducing this cost by moving the early postoperative anticoagulation monitoring into the community. Delayed discharge is an important consideration in the economic issues that surround the choice of thromboprophylaxis.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
| Journal or Publication Title: | Annals of The Royal College of Surgeons of England | ||||
| Publisher: | The Royal College of Surgeons of England | ||||
| ISSN: | 0035-8843 | ||||
| Official Date: | 2008 | ||||
| Dates: |
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| Volume: | Vol.90 | ||||
| Number: | No.6 | ||||
| Page Range: | pp. 500-503 | ||||
| DOI: | 10.1308/003588408X300957 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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