Advertisement

Topics

Venous thromboembolism and bleeding after total knee and hip arthroplasty. Findings from the Spanish National Discharge Database.

Summary of "Venous thromboembolism and bleeding after total knee and hip arthroplasty. Findings from the Spanish National Discharge Database."

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%
CI:
0.51-0.63) with deep-vein thrombosis (DVT), 1.20% (95%
CI:
1.12-1.30) had bleeding complications, and 0.09% (95%
CI:
0.07-0.12) died. Of 54 patients who died, 20.4% (95%
CI:
10.7-35.4) had been diagnosed with PE, 3.70% (95%
CI:
0.63-11.7) with DVT, and 13.0% (95%
CI:
5.67-25.6) had bled. Of 31,769 patients undergoing elective THA, 0.23% (95%
CI:
0.18-0.29) were diagnosed with PE, 0.44% (95%
CI:
0.37-0.52) with DVT, 1.21% (95%
CI:
1.10-1.34) bled, and 0.16% (95%
CI:
0.12-0.21) died. Of 52 patients who died, 13.5% (95%
CI:
6.08-24.8) had been diagnosed with PE, and 9.61% (95%
CI:
3.52-21.3) had bled. On multivariable analysis, PE (odds ratio [OR]: 157; 95%
CI:
75-328), DVT (
OR:
6.3; 95%
CI:
1.5-27) and bleeding (
OR:
8.5; 95%
CI:
3.6-20) were independent predictors for death after TKA. After THA, only PE (
OR:
65; 95%
CI:
26-160) and bleeding (
OR:
6.4; 95%
CI:
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.

Affiliation

Prof. Manuel Monreal, MD, PhD, Servicio de Medicina Interna, Hospital Universitario Germans Trias i Pujol, 08916 Badalona (Barcelona), Spain, E-mail: mmonreal.germanstrias@gencat.cat.

Journal Details

This article was published in the following journal.

Name: Thrombosis and haemostasis
ISSN: 0340-6245
Pages:

Links

DeepDyve research library

PubMed Articles [17455 Associated PubMed Articles listed on BioPortfolio]

Prophylaxis Against Venous Thromboembolism After Total Hip and Knee Arthroplasty: A Critical Analysis Review.

Low-Dose Aspirin Is Effective Chemoprophylaxis Against Clinically Important Venous Thromboembolism Following Total Joint Arthroplasty: A Preliminary Analysis.

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...

Efficacy and safety of rivaroxaban thromboprophylaxis after arthroplasty of the hip or knee: retrospective cohort study.

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...

Intraarticular Administration of Tranexamic Acid is Safe and Effective in Total Knee Arthroplasty Patients at High-Risk for Thromboembolism.

Tranexamic acid (TXA) is an antifibrinolytic agent that can be used to reduce blood loss in total knee arthroplasty (TKA) patients. Due to its thrombogenic properties, intravenous (IV) TXA is contrain...

Outpatient Total Hip Arthroplasty, Total Knee Arthroplasty, and Unicompartmental Knee Arthroplasty: A Systematic Review of the Literature.

The demand for total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) is growing rapidly because of the proven success of these procedures and an inc...

Clinical Trials [5030 Associated Clinical Trials listed on BioPortfolio]

A Phase 3 Study of DU-176b, Prevention of Venous Thromboembolism in Patients After Total Knee Arthroplasty

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...

Prevention of Venous Thromboembolism in Patients Undergoing Elective Total Knee Replacement Surgery (TREK)

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...

Predicting Bleeding Risk on Anticoagulant Therapy for Venous Thromboembolism

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...

A Study of BIBR 1048 in Prevention of Venous Thromboembolism in Patients With TKR Surgery.

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...

Total Knee Arthroplasty And Thromboembolism: A Comparison Between Two Surgical Techniques

In patients undergoing total knee arthroplasty, thromboembolism is a common occurrence, especially following tourniquet deflation. The resulting cardiopulmonary emboli can potentially lea...

Medical and Biotech [MESH] Definitions

Replacement of the knee joint.

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.

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.

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.

Quick Search
Advertisement
 


DeepDyve research library

Relevant Topics

Orthopedics
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 ...

Rheumatology
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...


Searches Linking to this Article