Thrombosis
In South Africa, 200,000 people suffer from deep vein thrombosis every year, and 20,000 die as a result of venous thromboembolism (VTE).1
VTE is a major cause of morbidity and mortality worldwide.2,3 Despite being preventable, pulmonary embolism contributes to 10% of all hospital deaths – making it the most common cause of preventable deaths in hospital patients.4
In many countries, including South Africa, medications to prevent VTE are underprescribed – resulting in unacceptable rates of morbidity and mortality.4
The most rational means of reducing morbidity and mortality for those at moderate- to severe-risk of VTE is the identification and primary prevention of risk factors (using risk assessment and stratification) with subsequent appropriate anti-thrombotic prophylaxis.1
Without prophylaxis the overall VTE incidence in hospitalised patients (medical and general surgery) is 10–40%, and this climbs to an alarming 40–60% in patients undergoing major orthopaedic surgery.5
With routine VTE prophylaxis, however, fatal pulmonary embolism is uncommon in orthopaedic patients and the rate of post-operative symptomatic VTE within three months drops to only 1.3–10%.5
Awolesi D, Naidoo M, Cassimijee MH. The Profile and Frequency of Known Risk Factors or Comorbidities for Deep Vein Thrombosis in an Urban District Hospital in KwaZulu-Natal. South Afr J HIV Med. 2016;17(1). doi:10.4102/sajhivmed.v17i1.425
Wendelboe AM, Raskob GE. Global Burden of Thrombosis: Epidemiologic Aspects. Circ Res. 2016;118(9):1340-1347. doi:10.1161/CIRCRESAHA.115.306841
Di Nisio M, van Es N, Büller HR. Deep Vein Thrombosis and Pulmonary Embolism. The Lancet. 2016;388(10063):3060-3073. doi:10.1016/S0140-6736(16)30514-1
Jacobson BF, Louw S, Büller H, et al. Venous Thromboembolism: Prophylactic and Therapeutic Practice Guideline. S Afr Med J. 2013;103(4):260. doi:10.7196/SAMJ.6706
Flevas DA, Megaloikonomos PD, Dimopoulos L, et al. Thromboembolism Prophylaxis in Orthopaedics: An Update. EFORT Open Reviews. 2018;3(4):136-148. doi:10.1302/2058-5241.3.170018