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Gender differences of venous thromboembolism risk after total hip and total knee arthroplasty: a meta-analysis

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Abstract

We performed a meta-analysis to evaluate gender differences of venous thromboembolism (VTE) risk after total hip (THA) and total knee arthroplasty (TKA). We searched PubMed and Web of Knowledge from their beginning to 25 July 2015. Pooled odds ratio (OR) and 95 % confidence interval (CI) for VTE risk were calculated. Twenty studies with 7,892,585 patients were included in our study. The VTE incidence ranged from 0.27 to 61.0 %. The sex ratio (male/female) was 0.623 (3,016,648/4,839,785) in no VTE group versus 0.492 (11,926/24,226) in VTE group. The pooled OR was 1.184 (95 % CI 1.070–1.310; Z = 3.28, P = 0.001). The Begg’s test (z = 1.46, P = 0.144) and the Egger’s test (t = 0.58, P = 0.571), and the funnel plot suggested there was no significant publication bias. Sensitivity analysis by omitted a study with largest simple size showed the pooled OR was 1.166 (95 % CI 1.051–1.294; Z = 2.91, P = 0.004) by random-effects model. Meta-regression showed VTE risk was not related with THA and TKA incidence (t = 0.35, P = 0.732). Our meta-analysis showed female patients have slightly higher risk of VTE than male patients after THA and TKA.

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Acknowledgments

We thank the editor and anonymous reviewers for several insightful comments that significantly improved the paper. We are also grateful to anonymous reviewer for correcting syntax error the paper.

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Authors and Affiliations

  1. First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People’s Republic of China

    Yue Lu & Hui-Lin Yang

  2. Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People’s Republic of China

    Yue Lu, Zhen-Yu Zhou, Ya-Ke Liu & Fan Liu

  3. Nantong University, Nantong, Jiangsu, People’s Republic of China

    Hong-Lin Chen

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  1. Yue Lu
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Correspondence to Fan Liu.

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Appendix: Search strategy

Appendix: Search strategy

For Pubmed

#1 “arthroplasty, replacement, hip”[MeSH Terms]

#2 “arthroplasty, replacement, knee”[MeSH Terms]

#3 #1 OR #2

#4 “venous thromboembolism”[MeSH Terms]

#5 “venous thrombosis”[MeSH Terms]

#6 “pulmonary embolism”[MeSH Terms]

#7 #4 OR #5 OR #6

#8 risk [Title/abstract]

#9 # 3 AND #7 AND #8

For Web of Knowledge

#1 TS = total hip arthroplasty

#2 TS = total hip replacement

#3 TS = total knee arthroplasty

#4 TS = total knee replacement

#5 #1 OR #2 OR #3 OR #4

#6 TS = venous thromboembolism

#7 TS = deep venous thrombosis

#8 TS = pulmonary embolism

#9 #6 OR #7 OR #8

#10 TS = risk

#11 # 5 AND #9 AND #10

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Lu, Y., Zhou, ZY., Liu, YK. et al. Gender differences of venous thromboembolism risk after total hip and total knee arthroplasty: a meta-analysis. J Thromb Thrombolysis 41, 556–562 (2016). https://doi.org/10.1007/s11239-015-1283-6

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