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The incidence of symptomatic in-hospital VTEs in Asian patients undergoing joint arthroplasty was low: a prospective, multicenter, 17,660-patient-enrolled cohort study

Knee Surgery, Sports Traumatology, Arthroscopy volume 27, pages 1075–1082 (2019)Cite this article

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.

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Funding

This research was funded by the National Natural Science Foundation of China Program (81601936), Department of Science and Technology of Sichuan Province (2018HH0141) and Health Department of Sichuan Province (18ZD016).

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Affiliations

  1. Department of Orthopaedic Surgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China

    Yi Zeng, Haibo Si, Yuangang Wu, Jing Yang, Zongke Zhou, Pengde Kang, Fuxing Pei & Bin Shen

Authors
  1. Yi Zeng
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  2. Haibo Si
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  3. Yuangang Wu
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  4. Jing Yang
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  5. Zongke Zhou
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  6. Pengde Kang
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  7. Fuxing Pei
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  8. Bin Shen
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Corresponding author

Correspondence to Bin Shen.

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Conflict of interest

All authors declare that they have no conflict of interest with other people or organizations that could inappropriately influence this work.

Ethical approval

This study was registered with the Chinese Clinical Trial Registry (ChiCTR-EOC-16009287). IRB Approval (2012-268) was obtained from the Clinical Trials and Biomedical Ethics Committee of West China Hospital.

Informed consent

Written informed consent was obtained from all the participants.

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Zeng, Y., Si, H., Wu, Y. et al. The incidence of symptomatic in-hospital VTEs in Asian patients undergoing joint arthroplasty was low: a prospective, multicenter, 17,660-patient-enrolled cohort study. Knee Surg Sports Traumatol Arthrosc 27, 1075–1082 (2019). https://doi.org/10.1007/s00167-018-5253-3

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  • DOI: https://doi.org/10.1007/s00167-018-5253-3

Keywords

  • Total knee replacement
  • TKA
  • TKR
  • Total hip arthroplasty
  • Total knee arthroplasty
  • Venous thromboembolism
  • Deep vein thrombosis
  • Pulmonary embolism
  • Incidence
  • Risk factors