Track topics on Twitter Track topics that are important to you
The impact of venous thromboembolism (VTE) and bleeding in patients undergoing major joint surgery has not been thoroughly studied. The Spanish National Discharge Database during the years 2005-2006 was used to assess the frequency and clinical impact of VTE and bleeding after elective total knee (TKA) or hip (THA) arthroplasty. Of 58,037 patients undergoing TKA, 0.18% (95% confidence interval [CI]: 0.15-0.22) were diagnosed with pulmonary embolism (PE), 0.57% (95%
0.51-0.63) with deep-vein thrombosis (DVT), 1.20% (95%
1.12-1.30) had bleeding complications, and 0.09% (95%
0.07-0.12) died. Of 54 patients who died, 20.4% (95%
10.7-35.4) had been diagnosed with PE, 3.70% (95%
0.63-11.7) with DVT, and 13.0% (95%
5.67-25.6) had bled. Of 31,769 patients undergoing elective THA, 0.23% (95%
0.18-0.29) were diagnosed with PE, 0.44% (95%
0.37-0.52) with DVT, 1.21% (95%
1.10-1.34) bled, and 0.16% (95%
0.12-0.21) died. Of 52 patients who died, 13.5% (95%
6.08-24.8) had been diagnosed with PE, and 9.61% (95%
3.52-21.3) had bled. On multivariable analysis, PE (odds ratio [OR]: 157; 95%
75-328), DVT (
1.5-27) and bleeding (
3.6-20) were independent predictors for death after TKA. After THA, only PE (
26-160) and bleeding (
2.3-17) predicted the risk for death. Bleeding, DVT, and PE, arising after TKA were all independent predictors for death. Their increase in risk was, however, substantially higher for PE. After THA, only PE and bleeding independently predicted death.
Prof. Manuel Monreal, MD, PhD, Servicio de Medicina Interna, Hospital Universitario Germans Trias i Pujol, 08916 Badalona (Barcelona), Spain, E-mail: firstname.lastname@example.org.
This article was published in the following journal.
Name: Thrombosis and haemostasis
Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthropla...
Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that...
Recently, anatomical designs in total knee arthroplasty are introduced to address asymmetry of the resected tibia cutting surface. It is still not well known how much improvement would be achieved in ...
Introduction Venous thromboembolism (VTE) is a potentially fatal complication of hip arthroplasty and knee arthroplasty. The National Institute for Health and Care Excellence recommend rivaroxaban for...
Despite the large increase in total hip arthroplasties and total knee arthroplasties, the incidence and prevalence of additional contralateral or ipsilateral joint arthroplasty are poorly understood. ...
The objective of this study is to assess the efficacy and safety of DU-176b compared with enoxaparin sodium for the prevention of venous thromboembolism in patients after elective total k...
The primary objective is to demonstrate the efficacy of AVE5026 for prevention of Venous Thromboembolism (VTE) in patients undergoing elective Total Knee Replacement (TKR) surgery. The se...
The main objective of the study is to develop or validate a clinical prediction rule for major bleeding in patients on oral anticoagulant therapy who have been safely anticoagulated witho...
The goal of this study is to evaluate the comparative efficacy and safety of three different doses ( 110 mg, 150 mg, 220 mg) of BIBR 1048 (Dabigatran etexilate) orally, compared to placebo...
This is an early user evaluation of the robotic-assisted total knee arthroplasty platform. The objective of this surgeon group is to capture data on the defined objectives and provide Stry...
Replacement of the knee joint.
Agents acting to arrest the flow of blood. Absorbable hemostatics arrest bleeding either by the formation of an artificial clot or by providing a mechanical matrix that facilitates clotting when applied directly to the bleeding surface. These agents function more at the capillary level and are not effective at stemming arterial or venous bleeding under any significant intravascular pressure.
Impaired venous blood flow or venous return (venous stasis), usually caused by inadequate venous valves. Venous insufficiency often occurs in the legs, and is associated with EDEMA and sometimes with VENOUS STASIS ULCERS at the ankle.
Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream.
A vascular anomaly characterized by a radial or wedge-shaped arrangement of dilated VEINS draining into a larger vein in the brain, spinal cord, or the meninges. Veins in a venous angioma are surrounded by normal nervous tissue, unlike a CENTRAL NERVOUS SYSTEM CAVERNOUS HEMANGIOMA that lacks intervening nervous tissue. Drainage of venous angioma is fully integrated with the body's venous system, therefore, in most cases there is no clinical signs and rare bleeding.
Arthroplasty Joint Disorders Orthopedics Spinal Cord Disorders Orthopedics is the science or practice of correcting deformities caused by disease or damage to the bones and joints of the skeleton. This specialized branch of surgery may ...
Arthritis Fibromyalgia Gout Lupus Rheumatic Rheumatology is the medical specialty concerned with the diagnosis and management of disease involving joints, tendons, muscles, ligaments and associated structures (Oxford Medical Diction...