{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:13:43Z","timestamp":1777936423923,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5R01HL106029"],"award-info":[{"award-number":["5R01HL106029"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5T32HL007224"],"award-info":[{"award-number":["5T32HL007224"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Trends in prescription for venous thromboembolism (VTE) prophylaxis following total hip (THR) and knee replacement (TKR) since the approval of direct oral anticoagulants (DOACs) and the 2012 guideline endorsement of aspirin are unknown, as are the risks of adverse events. We examined practice patterns in the prescription of prophylaxis agents and the risk of adverse events during the in-hospital period (the \u2018in-hospital sample\u2019) and 90 days following discharge (the \u2018discharge sample\u2019) among adults aged \u2a7e 65 undergoing THR and TKR in community hospitals in the Institute for Health Metrics database over a 30-month period during 2011 to 2013. Eligible medications included fondaparinux, DOACs, low molecular weight heparin (LMWH), other heparin products, warfarin, and aspirin. Outcomes were validated by physician review of source documents: VTE, major hemorrhage, cardiovascular events, and death. The in-hospital and the discharge samples included 10,503 and 5722 adults from 65 hospitals nationwide, respectively (mean age 73, 74 years; 61%, 63% women). Pharmacologic prophylaxis was near universal during the in-hospital period (93%) and at discharge (99%). DOAC use increased substantially and was the prophylaxis of choice for nearly a quarter (in-hospital) and a third (discharge) of the patients. Aspirin was the sole discharge prophylactic agent for 17% and 19% of patients undergoing THR and TKR, respectively. Warfarin remained the prophylaxis agent of choice for patients aged 80 years and older. The overall risk of adverse events was low, at less than 1% for both the in-hospital and discharge outcomes. The low number of adverse events precluded statistical comparison of prophylaxis regimens.<\/jats:p>","DOI":"10.1177\/1358863x20927096","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T14:59:00Z","timestamp":1591714740000},"page":"450-459","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Temporal trends in pharmacologic prophylaxis for venous thromboembolism after hip and knee replacement in older adults"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1174-7535","authenticated-orcid":false,"given":"Darae","family":"Ko","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Medicine, Boston University Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alok","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, University of Massachusetts Medical School, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam J","family":"Rose","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Boston University Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amresh D","family":"Hanchate","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Boston University Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Miller","sequence":"additional","affiliation":[{"name":"Center for Healthcare Organization and Implementation Research, Bedford VA, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R","family":"Winter","sequence":"additional","affiliation":[{"name":"Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph N","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori E","family":"Henault","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Boston University Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Fredman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan J","family":"Walkey","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy, Sleep, and Critical Care, Boston University Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yorghos","family":"Tripodis","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Karcz","sequence":"additional","affiliation":[{"name":"Institute for Health Metrics, Cambridge, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine M","family":"Hylek","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Boston University Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"key":"bibr1-1358863X20927096","volume-title":"The Surgeon General\u2019s call to action to prevent deep vein thrombosis and pulmonary embolism","author":"Office of the Surgeon General (US); 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