Necessity of chemo-prophylaxis for venous thromboembolism in hip surgeries

Venous thromboembolism is a significant and common complication of lower limb orthopaedic surgeries. The usage of thrombo-prophylaxis in lower limb trauma, spine trauma and replacement surgeries is gaining importance and is strictly followed in many hospital set-ups now a days. The most common reason for not using chemo-prophylaxis is uncertainty regarding the safest and most effective agent. Usage of thrombo-prophylaxis in trauma surgeries is not yet standardised and practiced in India. In this study we assess the incidence of symptomatic DVT or PE following hip surgeries who were given mechanical DVT prophylaxis post-operatively and there by justifying the necessity of chemo-prophylaxis. 49 patients who underwent hip surgeries from Jun-2012 to May- 2013 were included in the study. All the patients case records are studied regarding clinical symptoms of DVT or PE prior discharge and post discharge morbidity or mortality 6 months follow up. 2 (50) patients out of 4 who were already on anticoagulant treatment and continued postoperatively died within 6 months of surgery. Out of 38 patients who didnt receive any form of chemoprophylaxis 5 (13) patients died at 6months follow-up. By this study we conclude that mechanical prophylaxis, early passive and active mobilisation post-operatively may decrease the necessity of chemo-prophylaxis and routine use of chemo-prophylaxis is still debatable in hip surgeries.