Fatal pulmonary embolism after total hip replacement.

H O Fredin; A S Nillius

doi:10.3109/17453678208992234

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Fatal pulmonary embolism after total hip replacement.

H O Fredin·A S Nillius

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Abstract

A retrospective study of fatal pulmonary embolism (FPE) was carried out in 1,324 cases of total hip replacement (THR), performed during 1969 to 1978. Dextran 70 (Macrodex 6 per cent in saline. Pharmacia AB, Sweden) was given as thromboembolic prophylaxis. Sixteen patients died within 3 months. Autopsy was performed in 14 cases. Nine died from embolism, which makes an incidence of 0.7 per cent. Autopsy was performed in 8 of these cases. Seven patients died during the second and third week. Five patients had complained of acute chest pain and 4 of them had chest radiograms taken, which were normal. Only one patient had clinical symptoms of deep vein thromboses. Perfusion lung scan was performed as a screening procedure in 3 cases, all of them showing defects typical of pulmonary embolism. Four patients died from FPE, despite heparin therapy for 3-5 days. A comparison between patients with FPE and a control group showed that premonitory attacks of acute chest pain and previous operations for orthopaedic reasons were significantly more common in patients with FPE (P less than 0.001 and P less than 0.05), respectively). No difference could be found between the groups concerning blood loss, amount of transfusion, sex, operated side, type of prosthesis and weight.

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Aged Dextrans Female Heparin Hip Hip Prosthesis Humans Male Middle Aged Pain Pulmonary Embolism Radiography Retrospective Studies Thrombophlebitis Comparative Study Journal Article Research Support, Non-U.S. Gov't

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H O Fredin, A S Nillius. 1982. Fatal pulmonary embolism after total hip replacement.. https://doi.org/10.3109/17453678208992234

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