Trends of thromboprophylaxis and complications after major lower limb orthopaedic surgeries in Korea: National Health Insurance Claim Data

Abstract

Background: In Western countries, prophylaxis for venous thromboembolism (VTE) following major lower limb orthopaedic surgeries is recommended. However, that has not been the case in Asian countries, where the reported incidence of postoperative VTE has been low. The present study examined trends in VTE prophylaxis prescriptions and related complications following major lower limb orthopaedic surgeries in South Korea.

Design/participants: Using claim data from the National Health Insurance Corporation, 263,664 patients aged 65years or older who underwent major orthopaedic surgeries (total hip arthroplasty [THA], total knee arthroplasty [TKA], or hip fracture surgery [HFS]) between 2008 and 2012 were included.

Result: The prescription rate for VTE prophylaxis has increased from 62.4% in 2008 to 75.4% in 2012 (P<0.001). The prescription rate for new oral anticoagulants following THA and TKA has increased drastically since 2010, while that following HFS has not. Instead, prophylactic use of aspirin or low molecular weight heparin has increased in HFS cases. The rate of postoperative complications has significantly increased annually only in HFS: VTE (P=0.018) and brain haemorrhage or gastrointestinal bleeding (P=0.019).

Conclusion: This result could suggest the need for more studies about the use of VTE prophylactic medicines following HFS.

Keywords: Anticoagulant drug; Guideline; Haemorrhage; Hip fracture; Venous thromboembolism.