Venous thromboembolism rates in patients with lower limb immobilization after Achilles tendon injury are unchanged after the introduction of prophylactic aspirin: audit
We report a follow-up audit of the incidence of venous thromboembolism (VTE) in patients requiring lower limb immobilization due to Achilles tendon injury, since the introduction of a policy to routinely prescribe 100mg aspirin daily.
We studied 218 patients aged 18 to 65 who attended the Orthopaedic Assessment Unit at Wellington Hospital between January 2013 and December 2014 with Achilles tendon injury requiring lower limb immobilization for greater than one week. Information on assessment of VTE risk, prescription of aspirin and symptomatic VTE occurring within 70 days of immobilization was obtained and compared to the same information collected by the same method in the same patient group between January 2006 and December 2007, before the policy to routinely prescribe aspirin was introduced.
A total of 189/218 (93%) patients were prescribed aspirin, compared to 0.5% previously. Fourteen patients (6.4%, 95% CI 3.6% to 10.5%) developed symptomatic radiologically confirmed VTE, (10 distal deep-vein thromboses (DVT), two proximal DVT, one pulmonary embolism (PE) and one PE with distal DVT). Aspirin was prescribed to all patients who subsequently developed a VTE; in 1/14 a recognized risk factor was documented. The VTE incidence was similar to the 6.3% identified in the previous audit.
Lower limb immobilization following Achilles tendon injury confers a high risk of VTE even with aspirin prophylaxis. Consideration should be given to prophylaxis with low molecular weight heparin during lower limb immobilization following Achilles tendon injury, which has proven efficacy in this clinical situation. This article is protected by copyright. All rights reserved.
This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 September 2016.
All research outputs
#2,918,366
of 34,410,315 outputs
Outputs from Journal of Thrombosis & Haemostasis
#685
of 5,346 outputs
Outputs of similar age
#39,754
of 452,215 outputs
Outputs of similar age from Journal of Thrombosis & Haemostasis
#19
of 68 outputs
Altmetric has tracked 34,410,315 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,346 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.2. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 452,215 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 68 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.
