Risk factors for pulmonary embolism after hip and knee arthroplasty: a population-based study

Memtsoudis, Stavros G.; Besculides, Melanie; Gaber, Licia; Liu, Spencer; Valle, Alejandro González Della

doi:10.1007/s00264-008-0659-z

Cited by 105 publications

(63 citation statements)

References 34 publications

(30 reference statements)

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“…Considering the burden of these diseases within the older population, it is not surprising that among all comorbidities, cardiovascular diseases present the most significant risk for VTE. However, in contrast to our results, some investigators have reported that coronary artery disease is a poor predictor of VTE, or can even diminish the risk of VTE [9,11], possibly due to general better health in the populations of these countries or stricter criteria for monitoring and treatment of cardiovascular diseases, including earlier aggregation therapy. The limitations of our study are the relatively small number of patients with follow-up only during the hospitalisation period.…”

Section: Discussioncontrasting

confidence: 56%

“…Most cases of symptomatic VTE present following discharge from hospital and often result in hospital readmissions [5], although VTE can often be asymptomatic and the first signs of a PE can be sudden death. With this in mind many surgeons now administer prolonged thromboprophylaxis, and there have been significant advances in the use of regional anaesthetic techniques and oral pharmacological anticoagulants [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study

Marković-Denić¹,

Živković

Lešić

et al. 2012

International Orthopaedics (SICOT)

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Purpose Venous thromboembolism (VTE) is a common complication of orthopaedic surgery in the industrialised world; though there may be variability between population groups. This study aims to define the incidence and risk factors for symptomatic VTE following primary elective total hip and knee arthoplasty surgery in a single centre in Eastern Europe. Methods This prospective study included 499 adult patients undergoing total hip and knee arthroplasty for symptomatic osteoarthritis over a two-year period at the Clinic of Orthopaedic Surgery and Traumatology, Belgrade. Results The overall rate of confirmed symptomatic VTE during hospitalisation was 2.6%. According to the univariate logistic regression, an age greater than 75 years (OR03.08; 95%CI01.01-9.65), a family history of VTE (OR06.61; 95% CI01.33-32.90), varicose veins (OR03.13; 95% CI01.03-9.48), and ischemic heart disease (OR04.93; 95% CI01.61-15.09) were significant risk factors for in-hospital VTE.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study

Marković-Denić¹,

Živković

Lešić

et al. 2012

International Orthopaedics (SICOT)

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“…Older age, female gender, obesity, underlying disease, type of anesthesia, simultaneous bilateral THAs, surgical approach, and prolonged immobilization in bed are known risk factors for DVT and PE in studies of patients from Western countries [2,19,21,30]. After multivariate analysis in this study, prolonged immobilization was identified as a risk factor for DVT.…”

Section: Discussionmentioning

confidence: 86%

Deep Venous Thrombosis and Pulmonary Embolism are Uncommon in East Asian Patients after Total Hip Arthroplasty

Kang

Lee

Kim

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background In Western countries, deep vein thrombosis (DVT) and pulmonary embolism (PE), are relatively common after THA and many surgeons recommend routine pharmacologic thromboprophylaxis. There is some suggestion in the literature that the incidences of DVT and PE may be lower in East Asian patients. Therefore, it would be important to establish the incidences in a large number of East Asian patients who did not receive pharmacologic thromboprophylaxis.Purpose We therefore determined the incidence of DVT and PE and evaluated the associated risk factors in a series of East Asian patients who underwent primary THA without pharmacologic prophylaxis. Methods We retrospectively evaluated all 861 patients who underwent 992 elective primary THAs from May 2003 to December 2009. We identified patients with symptomatic DVT, symptomatic PE, and fatal PE. For potential risk factors we considered age, gender, body mass index (BMI), administration of aspirin, type of anesthesia, operation time, approach, simultaneous bilateral THAs, and duration of immobilization between symptomatic and asymptomatic patients. Results We identified eight patients with symptomatic DVT, one of whom also had a symptomatic PE; there were no cases of fatal PE. The incidences of fatal PE, symptomatic PE, and symptomatic DVT were 0 %, 0

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“…The effects of obesity on outcomes such as venous thromboembolism (VTE), wound complications, infection, and bleeding in patients undergoing total joint arthroplasties have been documented in numerous studies [4,6,7,13,15,18,20,21]. However, large studies to determine the effect size of morbid obesity on early postoperative complications after THA or TKA are lacking.…”

Section: Introductionmentioning

confidence: 99%

Complication Rates After Hip or Knee Arthroplasty in Morbidly Obese Patients

Friedman¹,

Hess

Berkowitz

et al. 2013

Clinical Orthopaedics &Amp; Related Research

166

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Background Morbid obesity has been shown to be a risk factor for increased complications after THA and TKA; however, large studies that would determine the effect size are lacking. Questions/purposes The purposes of this study were to determine whether morbid obesity increased the risk of: (1) venous thromboembolism (VTE), (2) bleeding, (3) other adverse events, and (4) infections during the early postoperative period (up to 6 to 8 weeks) after THA or TKA? Methods Data from the REgulation of Coagulation in ORthopaedic surgery to prevent Deep vein thrombosis and pulmonary embolism (RECORD) clinical trial program of rivaroxaban for prevention of VTE after THA or TKA were analyzed retrospectively. Data for 12,355 patients were reviewed to identify complication rates in morbidly obese patients (BMI C 40 kg/m 2 ) compared with patients with a BMI less than 40 kg/m 2 . Explorative analyses compared the rates of asymptomatic deep vein thrombosis (DVT), symptomatic DVT, symptomatic pulmonary embolism, bleeding, and other adverse events by BMI group. Results There were no significant differences in asymptomatic DVT, symptomatic DVT, symptomatic pulmonary embolism, or bleeding, but there were increases in other adverse events (including receipt of blood transfusion, erythema, peripheral edema, diarrhea, gastrointestinal or abdominal pain) and infections (including respiratory tract or lung infections, wound inflammation or infection, and extrasurgical-site infections), in patients with a BMI of 40 kg/m 2 or greater compared with patients with a BMI less than 40 kg/m 2 . Conclusions After THA or TKA, morbid obesity is not associated with an increased risk of VTE or bleeding but is associated with increased early postoperative complications, including erythema, peripheral edema, diarrhea and gastrointestinal or abdominal pain, wound inflammation or infection, extrasurgical-site infections, and respiratory tract or lung infections.

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Risk factors for pulmonary embolism after hip and knee arthroplasty: a population-based study

Abstract: Pulmonary embolism (

Cited by 105 publications

References 34 publications

Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study

Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study

Deep Venous Thrombosis and Pulmonary Embolism are Uncommon in East Asian Patients after Total Hip Arthroplasty

Complication Rates After Hip or Knee Arthroplasty in Morbidly Obese Patients

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