DEEP VENOUS THROMBOSIS AFTER ORTHOPEDIC-SURGERY IN ADULT CANCER-PATIENTS

Background and Objectives: Patients with cancer and patients undergoin g major orthopedic procedures are two groups at risk of deep venous th rombosis (DVT). The objective was to determine the rate of venous thro mboembolic disease in patients with a malignant neoplasm and major ort hopaedic surgery of the lower limb. Methods: The study included 169 pa tients. All patients were given knee-high intermittent pneumatic compr ession devices for prophylaxis. Postoperative surveillance for thrombo sis was performed on all patients with venous duplex doppler ultrasono graphy. Results: Proximal DVT occurred in 24 of 169 patients (14.2%). One patient (0.6%) developed a symptomatic, nonfatal pulmonary embolus (PE). The development of DVT was not associated with age, sex, type o f surgery, type of neoplasm, location, or pathologic fracture. The add ition of anticoagulant medication such as warfarin did not significant ly reduce the rate of DVT in a subset of 54 patients. In three patient s, the DVT occurred only in the contralateral limb, and in four patien ts, there were bilateral DVTs. Conclusions: When intermittent compress ion boots were used for prophylaxis in conjunction with ultrasound scr eening, the risk of proximal DVT was substantial (14.2%), but the rate of symptomatic PE was low (0.6%). (C) 1998 Wiley-Liss, Inc.