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Tytuł:
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Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty.
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Autorzy:
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Deng W; Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, China.
Huo L; Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, China.
Yuan Q; Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, 100035, Beijing, People's Republic of China.
Huang D; Department of Orthopedic, Beijing Jishuitan Hospital, Beijing, China.
Li Q; Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, China.
Tian W; Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, 100035, Beijing, People's Republic of China. .
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Źródło:
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BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2021 Jul 06; Vol. 22 (1), pp. 608. Date of Electronic Publication: 2021 Jul 06.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2000-
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MeSH Terms:
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Arthroplasty, Replacement, Hip*/adverse effects
Arthroplasty, Replacement, Knee*/adverse effects
Diabetes Mellitus*
Venous Thromboembolism*/diagnostic imaging
Venous Thromboembolism*/epidemiology
Anticoagulants ; China/epidemiology ; Female ; Heparin, Low-Molecular-Weight ; Humans ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Risk Factors
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References:
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Grant Information:
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No. Z161100000116091 Beijing Municipal Science and Technology Commission
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Contributed Indexing:
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Keywords: Deep venous thrombosis; Diabetes; Total hip arthroplasty; Total knee arthroplasty; Venous thromboembolism
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Substance Nomenclature:
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0 (Anticoagulants)
0 (Heparin, Low-Molecular-Weight)
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Entry Date(s):
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Date Created: 20210707 Date Completed: 20210708 Latest Revision: 20210710
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Update Code:
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20240105
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PubMed Central ID:
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PMC8261962
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DOI:
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10.1186/s12891-021-04453-9
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PMID:
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34229632
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Background: Venous thromboembolism (VTE) is a significant complication after joint arthroplasty. Diabetes is related to a few changes in coagulation and fibrinolysis that may lead to thrombophilia. We aimed to investigate the incidence of postoperative VTE and associated risk factors among patients with diabetes undergoing total hip (THA) or total knee anthroplasty (TKA) in a single centre in China.
Methods: Patients with diabetes who underwent THA or TKA from January 2016 to December 2018 (n = 400) at Beijing Jishuitan Hospital were recruited in this study. Lower limb venous Doppler ultrasound was performed before and after surgery to confirm deep venous thrombosis (DVT). Computer tomography pulmonary angiography was done to confirm pulmonary embolism (PE) for those with new postoperative DVT and typical symptoms of PE. A multivariate logistic regression model was conducted to examine factors associated with the development of postoperative VTE.
Results: The overall incidence of postoperative VTE in patients with diabetes after THA or TKA was 46.8 % (187 out of 400). Among the 187 VTE patients, 7.5 % (14 out of 187) had proximal vein thrombosis and 92.5 % (173 out of 187) had distal vein thrombosis. No PE occurred. Female patients and patients undergoing TKA had higher incidence of postoperative VTE. Patients who developed postoperative VTE were older, and had higher levels of preoperative D-Dimer and Caprini score. A high level of preoperative D-dimer (OR = 2.11, 95 %CI = 1.35-3.30) and the surgery of TKA (OR = 2.29, 95 %CI = 1.29-4.01) significantly increased the risk of developing postoperative VTE. Postoperative initiation of concomitant mechanical prophylaxis and low molecular weight heparin (LMWH) was protective for postoperative VTE (OR = 0.56, 95 %CI = 0.37-0.86).
Conclusions: VTE is common in patients with diabetes undergoing joint arthroplasty. Patients undergoing TKA or with a high level of preoperative D-dimer are at a considerable risk of developing postoperative VTE. There may be a protective role of postoperative initiation of concomitant mechanical prophylaxis and LMWH for VTE.
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