Methods: Af ter approval by the institutional ethics commit tee (No. 1584), we collected records of patients who had undergone TK A or THA from April 2011 through July 2013 at our institution. Among the 1263 screened patients, 100 (7.9%) were not eligible for the study. Patients were placed on one of the following anticoagulation regimens, enoxaparin 20 mg twice a day, fondaparinux 15 mg once a day or heparin for 7 days beginning 24 hours af ter surgery, if they have no contraindications. All patients had pneumatic compression devices and compression stockings until ambulation. One week af ter surgery, D-dimer was measured, and MDCT pulmonary arteriography and venography were performed for the diagnoses of PE and DVT, respectively. MDCTs were interpreted by staf f radiologists. Statistics: By using T-test, we compared patient characteristics, types of anesthesia or surgery-related variables and D-dimers of two cohorts, i.e., patients with PE or DVT and those without PE or DVT according to the MDCT diagnosis. Multivariate logistic regression analysis was performed to identif y the predicting risk factors to DVT and PE events. Results and Discussion: Among 1163 patients, 674 underwent THA and 489 TK A including unilateral knee arthroplasty. PE was detected in 20 (1.7%), and DVT in 44 (3.8%). The incidences of PE or DVT are significantly lower than those of previously reported 1) . The fact that the two cases of in-hospital death were unrelated with DVT or PE events supports the ef ficacy of our strict anticoagulation regimen. Although there were dif ferences in age, weight, duration of anesthesia between two cohorts, logistic regression analysis identified the type of surgery (TK A>THA), and D-dimer level as the predicting risk factors. Conclusions: With strict anticoagulation strategy, the incidences of PE or DVT events af ter TK A or THA are low. A high D-dimer level one week af ter surgery is suggestive of the events.
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