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Venous Thromboembolism Prophylaxis in Orthopedic Surgery

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Venous Thromboembolism Prophylaxis in Orthopedic Surgery

This slide set is based on a comparative effectiveness review (CER) titled Venous Thromboembolism Prophylaxis in Orthopedic Surgery, which was developed by the University of Connecticut/Hartford Hospital Evidence-based Practice Center for the Agency for Healthcare Research and Quality (AHRQ Contract No. 290-2007-10067-I) and is available online. The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information presented here is intended to help health care decisionmakers—clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This information is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, that is, in the context of available resources and circumstances presented by individual patients.

CERs are comprehensive systematic reviews of the literature and usually compare two or more types of treatments or interventions, such as different drugs, for the same condition. For the CER on venous thromboembolism (VTE) prophylaxis in orthopedic surgery, a systematic review of 179 articles published between January 1980 and May 2011 sought to determine the comparative effectiveness, benefits, and adverse effects of VTE prophylaxis for patients undergoing orthopedic surgery. This review did not cover the effectiveness of the oral direct factor Xa inhibitor, rivaroxaban. However, after this report was prepared, rivaroxaban was approved by the U.S. Food and Drug Administration (FDA). The comparative effectiveness of rivaroxaban versus enoxaparin from the four Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism (RECORD) trials are briefly reviewed in a separate section of this slide set. This continuing medical education activity is provided to assist in decisionmaking and does not represent clinical recommendations or guidelines. The full report is available at www.effectivehealthcare.ahrq.gov/thrombo.cfm.