Yi Zeng1, Haibo Si1, Yuangang Wu1, Jing Yang1, Zongke Zhou1, Pengde Kang1, Fuxing Pei1, Bin Shen2. 1. Department of Orthopaedic Surgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. 2. Department of Orthopaedic Surgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. shenbin_1971@163.com.
Abstract
PURPOSE: The aim of this study was to determine the real incidence of symptomatic in-hospital venous thromboembolism (VTE) and identify risk factors for VTEs in Asian patients undergoing total hip (THA) and total knee arthroplasty (TKA). METHODS: A total of 17,660 patients (20,078 hips and knees) undergoing THA and TKA at 78 hospitals were enrolled. The composite incidence of symptomatic in-hospital DVT and PE was identified as the primary effectiveness outcomes. The primary safety outcomes were the incidences of postoperative complications, especially for major or minor bleeding. Secondary analyses were assessed to identify the risk factors for postoperative VTE. RESULTS: The overall rates of symptomatic in-hospital DVT in patients undergoing THA and TKA were 0.21% (19/9022) and 0.36% (31/8638), respectively. Symptomatic PE was confirmed in one TKA patient. Safety analysis showed that the incidence of bleeding during hospital stays in patients undergoing THA and TKA was 0.10% (18/17,660). Increased VTE risks were associated with old age, high BMI index, hypertension, cerebrovascular disease, history of venous thromboembolism and no medical prophylaxis usage. CONCLUSIONS: The incidence of symptomatic VTEs in Asian regions was low compared with that reported in studies targeting Western populations. Approximately 1 in 500 patients undergoing THA and approximately 1 in 300 patients undergoing TKA developed symptomatic VTEs prior to hospital discharge. Old age, high BMI, history of venous thromboembolism, hypertension, cerebrovascular disease, and no medication prophylaxis were risk factors identified in this study. LEVEL OF EVIDENCE: Prospective cohort study; Level 2.
PURPOSE: The aim of this study was to determine the real incidence of symptomatic in-hospital venous thromboembolism (VTE) and identify risk factors for VTEs in Asian patients undergoing total hip (THA) and total knee arthroplasty (TKA). METHODS: A total of 17,660 patients (20,078 hips and knees) undergoing THA and TKA at 78 hospitals were enrolled. The composite incidence of symptomatic in-hospital DVT and PE was identified as the primary effectiveness outcomes. The primary safety outcomes were the incidences of postoperative complications, especially for major or minor bleeding. Secondary analyses were assessed to identify the risk factors for postoperative VTE. RESULTS: The overall rates of symptomatic in-hospital DVT in patients undergoing THA and TKA were 0.21% (19/9022) and 0.36% (31/8638), respectively. Symptomatic PE was confirmed in one TKA patient. Safety analysis showed that the incidence of bleeding during hospital stays in patients undergoing THA and TKA was 0.10% (18/17,660). Increased VTE risks were associated with old age, high BMI index, hypertension, cerebrovascular disease, history of venous thromboembolism and no medical prophylaxis usage. CONCLUSIONS: The incidence of symptomatic VTEs in Asian regions was low compared with that reported in studies targeting Western populations. Approximately 1 in 500 patients undergoing THA and approximately 1 in 300 patients undergoing TKA developed symptomatic VTEs prior to hospital discharge. Old age, high BMI, history of venous thromboembolism, hypertension, cerebrovascular disease, and no medication prophylaxis were risk factors identified in this study. LEVEL OF EVIDENCE: Prospective cohort study; Level 2.
Entities:
Keywords:
Deep vein thrombosis; Incidence; Pulmonary embolism; Risk factors; TKA; TKR; Total hip arthroplasty; Total knee arthroplasty; Total knee replacement; Venous thromboembolism
Authors: Lawrence C M Lau; Jason C H Fan; Kwong-Yin Chung; Kin-Wing Cheung; Gene C W Man; Yuk-Wah Hung; Carson K B Kwok; Kevin K W Ho; Kwok-Hing Chiu; Patrick S H Yung Journal: J Orthop Translat Date: 2020-03-30 Impact factor: 5.191
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