Thromboprophylaxis in Special Patients: Multiple Trauma, Head Trauma, and Spine Surgery

There is a significant clinical association between a traumatic event and the development of venous thromboembolism (VTE). In this chapter, we are reviewing VTE in patients with multiple trauma, head trauma, or acute spinal cord injury and in those underg

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Juan V. Llau Editor

Thromboembolism in Orthopedic Surgery

Editor Juan V. Llau, M.D., Ph.D. Department of Anaesthesiology and Critical Care University Hospital of Valencia Valencia Spain

ISBN 978-1-4471-4335-2 ISBN 978-1-4471-4336-9 DOI 10.1007/978-1-4471-4336-9 Springer London Heidelberg New York Dordrecht

(eBook)

Library of Congress Control Number: 2012950006 © Springer-Verlag London 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Preface

Venous thromboembolism in any of its kinds of presentation, pulmonary embolism and deep vein thrombosis, represents a major public health problem, affecting hundreds of thousands of people each year. Patients undergoing major orthopedic surgery have a particularly high risk for developing venous thromboembolism, and the need for thromboprophylaxis, most commonly pharmacological prophylaxis, has become standard of care for many years. In this field, the rationale for thromboprophylaxis has been widely demonstrated, as seen in the decrease of venographic and symptomatic deep vein thrombosis and symptomatic, asymptomatic, and fatal pulmonary embolism. But, due to the natural history of venous thromboembolism in patients undergoing major orthopedic surgery (mainly joint arthroplasty or hip fracture surgery), venous thro