• Int Orthop · Jan 2012

    Multicenter Study

    Thrombo-prophylaxis in pelvic and acetabular trauma patients: a UK consensus?

    • Enis Guryel, Rachel Pearce, Mark Rickman, and Martin Bircher.
    • Department of Trauma and Orthopaedic Surgery, Pelvic and Acetabular Unit, St George's Healthcare NHS Trust, Blackshaw Road, London SW17 0QT, UK. enisguryel@doctors.org.uk
    • Int Orthop. 2012 Jan 1; 36 (1): 165-9.

    AimsThe incidence of deep vein thrombosis, non-fatal pulmonary embolism and fatal pulmonary embolism may be as high as 61%, 10% and 2%, respectively, in patients with pelvic and acetabular injuries. A survey of the pelvic and acetabular units across the United Kingdom was performed to ascertain the thrombo-prophylaxis policy for these patients. In particular, questions were asked about different regimes on post-operative patients, conservatively managed patients and those simply discussed over the telephone. We enquired about their known rates of DVT and PE and their methods of data collection.MethodsPostal questionnaires were sent to 22 pelvic and acetabular trauma centres around the United Kingdom.ResultsReplies from 18 units were received in which a total of 837 operations are performed per year. Forty-five percent of pelvic and acetabular units do not routinely prescribe chemical prophylaxis for post-operative patients and 56% do not prescribe prophylaxis for conservatively managed patients. The policy of the remaining units showed no consistency in duration or agent. Fifty-three percent of units use a database to collect information related to the numbers of patients operated up on. Forty-seven percent have no defined method for collecting DVT and PE numbers. For this reason, reported rates of proximal DVT, non-fatal PE and fatal PE were below that expected at 2.5%, 0.8% and 0.1%, respectively.ConclusionsDespite high rates of thrombo-embolic complications in patients with pelvic and acetabular injuries there is no UK consensus on prescribing prophylaxis.

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