FATAL PULMONARY EMBOLISM FOLLOWING HIP AND KNEE SURGERY, A STUDY OF 2153 CASES USING SELECTIVE CHEMOPROPHYLAXIS

Abstract

In order to prevent fatal pulmonary embolism TED stockings, foot pumps and early mobilisation on the second post-operative day are used at our centre. Only patients deemed to be high risk (previous DVT/PE or obese) are given Clexane as an inpatient and Warfarin for six weeks post op. 1137 primary hips and 1017 primary knees were identified using the hospital database and the figures confirmed with the theatre implant order books. Those patients now deceased on the database had their death certificates obtained from the coroner. No patients had died from pulmonary embolism within three months post operation. 34 patients had been discharged on Warfarin according to the pharmacy records. We would therefore not recommend the routine use of chemical thromboprophylaxis following joint replacement.