UK Foot and Ankle Thromboembolism (UK FATE) Collaborative

The last BOFAS VTE position statement was published by BOFAS Scientific Committee in September 2017. NICE guidance on VTE prophylaxis for hip and knee arthroplasty has been amended since and helped units in the country to achieve a uniform approach in the management of this controversial clinical problem. There is wide variation in the threshold and provision of thromboprophylaxis in the treatment of foot and ankle conditions and units may have varying protocols. One of the difficulties in affecting change in practice in this area is the low incidence of postoperative, symptomatic VTE. Therefore, a large number of patients need to be included in any series for meaningful conclusions to be drawn.

 

Scope

The UK-FATE Audit was approved by the BOFAS Outcomes and Scientific Committees in March 2022, on the back of the success of the UK-FALCON Audit. As elective activity resumed in most units it was felt that it was an opportune moment for a UK-wire collaborative effort to help answer important questions about VTE and inform our future practice.

The primary aim was to analyse the 90-day incidence of symptomatic VTE related to elective foot and ankle surgery, trauma foot and ankle surgery and following the treatment of Achilles tendon ruptures (operative and non-operative).

Secondary aims were to assess the chemical anticoagulation variability in the UK and assimilate risk factors associated with development of symptomatic VTE in foot and ankle surgery in the UK.

 

Design

UK-wide Multicentre prospective national audit. Looked at datqa from 11,363 foot and ankle patients who underwent surgery in an operating theatre (or treatment for Achilles tendon ruptures) between the 1^{st of} June to 30^th of November 2022.  

 

Report

The study is now completed and the results are available in the report here (accessible to members only). 

 

Publications

Characteristics of Patients Not Receiving Chemical Thromboprophylaxis Following Foot and Ankle Surgery: Data From the Multicenter, Prospective UK Foot and Ankle Thrombo-Embolism Audit (UK-FATE). Foot Ankle Int. 2024 Jun 13:10711007241258159. 

UK-FATE Collaborative. The variation of anticoagulation prescribed in foot and ankle surgery in the UK - UK foot and ankle thrombo-embolism audit (UK-FATE). Foot Ankle Surg. 2024 Jun 26:S1268-7731(24)00146-2. 

 

Acknowledgements

We would like to extend our gratitude to all the members who participated in this important national foot and ankle project – without your efforts this would not have been possible.

We would also like to acknowledge University of Leicester Hospitals Charity for funding the project, and NIHR Leicester Biomedical Research Centre for managing the data.