Using Spatial and Map-Based Data Analysis to Explore the Epidemiology of Ruptured Abdominal Aortic Aneurysm and Identify Opportunities for Decreasing Associated Mortality

Abstract

years 2006 to 2011, to identify patients who underwent TKA. The presence or absence of post operative VTE, patient demographics, comorbidities, perioperative data, and outcomes were collected and analyzed.Results: A total of 29,139 TKAs were performed between 2006 and 2011. There were 503 patients who had VTE (VTE group) and the remainder did not have VTE (N-VTE group). The incidence of VTE after TKA was 1.73%. The VTE group had a higher proportion of patients who were aged >80 years (11.3% vs 9.5%, P ¼ .04), had recent myocardial infarction (27.4% vs 0.04%, P < .01), prior PTCA (6.67% vs 4.64%, P ¼ .03), and rest pain/gangrene (27.4% vs 0.04%, P < .01). Although the proportion of current smokers was not significantly different (8.35% vs 8.47%, P ¼ .92), the pack-year history was higher in the VTE group (4.82 6 1.17 pack/y vs 4.52 6 0.17 pack/y, P < .01). Multivariate regression analysis demonstrated that impaired sensorium and recent chemotherapy preoperatively were most significantly associated with VTE after TKA. Postoperative events, such as return to the operating room, prolonger mechanical ventilation, cardiac arrest, and myocardial infarction were all considered statistically significant. The Table lists the relative odds ratios with respective 95% confidence intervals and P values.Conclusions: Recent preoperative chemotherapy for malignancy and postoperative cardiopulmonary events are independent risk factors for the development of postoperative VTE in patients undergoing TKA. Randomized prospective studies should be performed to determine if perioperative VTE prophylaxis is beneficial in these high-risk patients.