{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:56:43Z","timestamp":1775473003395,"version":"3.50.1"},"reference-count":7,"publisher":"Medical Association of Zenica-Doboj","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicinski Glasnik"],"published-print":{"date-parts":[[2017,8,1]]},"abstract":"<jats:p>&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA\/TKA) at a single university-associated hospital in Croatia. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk). &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH). Overall, 228 (37.8%) patients received prophylaxis not involving warfarin, and 372 continued with short-term LMWH with switching to warfarin. They contributed a total of 1218 international normalized ratio (INR) values (median=3, range=1-8). These were consistently below the target INR range across the observed period. Between post-surgical days 6 and 15 (after the initial titration), 438 values were taken in patients treated with LMWH+warfarin and 92.7% were below, and only 6.8% within the target range; 580 values were taken in patients already switched to warfarin, 74% were below and only 25% within the range. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; The prevailing mode of VTE prophylaxis was in a clear contrast to (then) actual professional guidelines, with inadequate monitoring and poor anticoagulation. There is no reason to expect a substantially different situation at other institutions across the country. The prevailing practice of VTE prophylaxis in major orthopaedic surgery in Croatia should be promptly abandoned and updated in agreement with the current state of the art.&amp;lt;\/p&amp;gt;<\/jats:p>","DOI":"10.17392\/902-17","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T10:20:46Z","timestamp":1713694846000},"page":"244-249","source":"Crossref","is-referenced-by-count":0,"title":["Warfarin should not be used for thromboprohylaxis in elective major orthopaedic surgery: a Croatian perspective"],"prefix":"10.17392","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-6979","authenticated-orcid":false,"given":"Robert","family":"Kolund\u017ei\u0107","sequence":"first","affiliation":[{"name":"University Hospital Centre \u201cSestre Milosrdnice\u201d","place":["Zagreb,Croatia"],"department":["Department of Trauma Surgery"]},{"name":"School of Medicine, Josip Juraj Strossmayer University","place":["Osijek,Croatia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marijana","family":"\u0160imi\u0107 Jovi\u010di\u0107","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Zagreb","place":["Zagreb,Croatia"],"department":["Department of Orthopaedics"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"\u00d0inki\u0107","sequence":"additional","affiliation":[{"name":"Karaborg Hospital, Lidkoping","place":["Lidkoping,Sweden"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadija","family":"Petrovi\u0107","sequence":"additional","affiliation":[{"name":"University Hospital Centre \u201cSestre Milosrdnice\u201d","place":["Zagreb,Croatia"],"department":["Department of Trauma Surgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomislav","family":"Crnkovi\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine, Josip Juraj Strossmayer University","place":["Zagreb,Croatia"]},{"name":"County General Hospital","place":["Po\u017eega,Croatia"],"department":["Department of Orthopaedic and Trauma Surgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Trkulja","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb","place":["Zagreb,Croatia"],"department":["Department of Pharmacology"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"49509","published-online":{"date-parts":[[2017,8,1]]},"reference":[{"key":"ref1","first-page":"343","article-title":"Forty years of total hip replacement in Croatia at the department of orthopedic surgery Zagreb -orthopedic surgery of the 20 th century","author":"RKolund\u017ei\u0107R","year":"2011","unstructured":"Kolund\u017ei\u0107 R, Orli\u0107 D. Forty years of total hip repla-\ncement in Croatia at the department of orthopedic \nsurgery Zagreb -orthopedic surgery of the 20 th cen-\ntury. Lijec Vjesn 2011; 133:343-51.","journal-title":"Lijec Vjesn"},{"key":"ref2","article-title":"American College of Chest Physicians. Prevention of VTE in orthopedic surgery patients. Antithrombotic therapy and prevention of thrombosis 9 th ed: American College of Chest Physicians evidence-based clinical practice guidelines","author":"YFalck-YtterY","year":"2012","unstructured":"Falck-Ytter Y, Francis CW, Johanson NA, Curley \nC, Dahl OE, Schulman S, Ortel TL, Pauker SG, \nColwell CW Jr; American College of Chest Physi-\ncians. Prevention of VTE in orthopedic surgery \npatients. Antithrombotic therapy and prevention of \nthrombosis 9 th ed: American College of Chest Physi-\ncians evidence-based clinical practice guidelines. \nChest 2012; 141(suppl):e278S-e325S.","journal-title":"Chest"},{"key":"ref3","first-page":"10","article-title":"Use of warfarin for venous thromboembolism prophylaxis following knee and hip arthroplasty: results of the Michigan Anticoagulation Quality Improvement Initiative (MAQI2)","author":"GBarnesG","year":"2013","unstructured":"Barnes GD, Kaatz S, Golgotiu V, Gu X, Leidal A, \nKobeissy A, Haymart B, Kline-Rogers E, Kozlowski \nJ, Almany S, Leyden T, Froehlich JB. Use of war-\nfarin for venous thromboembolism prophylaxis \nfollowing knee and hip arthroplasty: results of the \nMichigan Anticoagulation Quality Improvement \nInitiative (MAQI2). J Thromb Thrombolysis 2013; \n35:10-4.","journal-title":"J Thromb Thrombolysis"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1185\/03007995.2011.614938","article-title":"Warfarin prophylaxis in patients after total knee or hip arthroplasty -international normalized ratio patterns and venous thromboembolism","author":"BNordstromB","year":"2011","unstructured":"Nordstrom BL, Kachroo S, Fraeman KH. Warfarin \nprophylaxis in patients after total knee or hip arthro-\nplasty -international normalized ratio patterns and \nvenous thromboembolism. Curr Med Res Opinion \n2011; 27:1973-85.","journal-title":"Curr Med Res Opinion"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"403","DOI":"10.3325\/cmj.2016.57.403","article-title":"Croatia needs a registry of patients undergoing direct current cardioversion for persistent atrial fibrillation\/ flutter","author":"MDubrav\u010di\u0107M","year":"2016","unstructured":"Dubrav\u010di\u0107 M, Cukon P, Car S, Puljevi\u0107 D, Trkulja V. \nCroatia needs a registry of patients undergoing direct \ncurrent cardioversion for persistent atrial fibrillation\/ \nflutter. Croat Med J 2016; 31:403-5.","journal-title":"Croat Med J"},{"key":"ref6","first-page":"25","article-title":"Safety of apixaban for venous thromboembolism prophylaxis: the evidence to date","author":"VTrkuljaV","year":"2016","unstructured":"Trkulja V. Safety of apixaban for venous thrombo-\nembolism prophylaxis: the evidence to date. Drug \nHealth Patient Saf 2016; 19:25-38.","journal-title":"Drug Health Patient Saf"},{"key":"ref7","first-page":"113","article-title":"Rivaroxaban vs. dabigatran for thromboprophylaxis after joint-replacement surgery: exploratory indirect comparison based on meta-analysis of pivotal clinical trials","author":"VTrkuljaV","year":"2010","unstructured":"Trkulja V, Kolund\u017ei\u0107 R. Rivaroxaban vs. dabiga-\ntran for thromboprophylaxis after joint-replacement \nsurgery: exploratory indirect comparison based on \nmeta-analysis of pivotal clinical trials. Croat Med J \n2010; 51:113-23.","journal-title":"Croat Med J"}],"container-title":["Medicinski Glasnik"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medicinskiglasnik.ba\/article\/396\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicinskiglasnik.ba\/article\/396\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:43:39Z","timestamp":1775468619000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicinskiglasnik.ba\/article\/id\/91\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,1]]},"references-count":7,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,8,1]]},"published-print":{"date-parts":[[2017,8,1]]}},"URL":"https:\/\/doi.org\/10.17392\/902-17","archive":["Internet Archive"],"relation":{},"ISSN":["1840-0132","1840-0132"],"issn-type":[{"value":"1840-0132","type":"electronic"},{"value":"1840-0132","type":"print"}],"subject":[],"published":{"date-parts":[[2017,8,1]]}}}