Does intermittent pneumatic compression increase the risk of pulmonary embolism in deep venous thrombosis after joint surgery?

Hou, Huacheng; Yao, Yao; Zheng, Ke; Teng, Huajian; Rong, Zhen; Chen, Dongyang; Xu, Zhihong; Shi, Dongquan; Dai, Jin; Li, Xinhua; Jiang, Qing

doi:10.1097/mbc.0000000000000387

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…Numerous studies have assessed the risk factors associated with the development of VTEs after total joint arthroplasty [15], [16], [17], [18]. Parvizi et al.…”

Section: Discussionmentioning

confidence: 99%

What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?

et al. 2018

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BackgroundPulmonary embolism and deep vein thrombosis, together referred to as venous thromboembolism (VTE), are serious and potentially preventable complications after total hip arthroplasty and total knee arthroplasty. The aim of this study was to investigate the incidence of mortality after VTE events and assess the risk factors that are associated with it.MethodsThe Nationwide Inpatient Sample was used to estimate the total number of total hip arthroplasty, total knee arthroplasty, VTE events, and mortality using the International Classification of Diseases, Ninth Revision procedure codes from 2003 to 2012. Patients' demographics, Elixhauser, and Charlson comorbidity indices were used to identify the risk factors associated with in-hospital VTEs and mortality.ResultsA total of 1,805,621 THAs and TKAs were included. The overall rate of VTE was 0.93%. The in-hospital mortality rate among patients with VTEs was 7.1% vs 0.30% in patients without VTEs (P-value < .0001). The risk factors for mortality after VTE events in descending order were as follows: hypercoagulable state (odds ratio [OR]: 5.3, 95% confidence interval [CI]: 3.6-5.8), metastatic cancer (OR: 5.2, 95% CI: 3.3-5.6), myocardial infarction (OR: 4.2, 95% CI: 2.3-4.7), peripheral vascular disease (OR: 3.6, 95% CI: 3.2-4.0), cardiac arrhythmias (OR: 3.2, 95% CI: 1.6-4.3), advanced age (OR: 3.1, 95% CI: 2.3-3.7), electrolyte disorders (OR: 3.1, 95% CI: 2.2-3.6), pulmonary circulation disorders (OR: 2.9, 95% CI: 2.6-3.3), depression (OR: 2.8, 95% CI: 1.6-3.4), complicated diabetes (OR: 2.7, 95% CI: 2.1-3.2), weight loss (OR: 2.6, 95% CI: 2.2-3.3), renal failure (OR: 2.6, 95% CI: 1.7-3.5), chronic pulmonary disease (OR: 2.5, 95% CI: 1.3-3.1), valvular disease (OR: 2.4, 95% CI: 1.8-2.7), liver disease (OR: 1.7, 95% CI: 1.2-1.9), and obesity (OR: 1.6, 95% CI: 1.5-1.9).ConclusionsIn-hospital VTE has a significant in-hospital mortality rate. Several of the identified risk factors in this study are modifiable preoperatively. We strongly urge the orthopaedic community to be cognizant of these risk factors and emphasize on optimizing patients' comorbidities before an elective arthroplasty.

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“…Numerous studies have assessed the risk factors associated with the development of VTEs after total joint arthroplasty [15], [16], [17], [18]. Parvizi et al.…”

Section: Discussionmentioning

confidence: 99%

What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?

et al. 2018

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“…Similarly, a prospective cohort study by Hou et al, assessed the safety of postoperative application of IPCD in patients with pre-existing DVT who were undergoing joint surgery. Their study suggests that IPCD reduces the risk of symptomatic PE in general patients after surgery without an increased rate of postoperative PE in those patients with distal DVT 1729 . In addition, a systematic review by Rabe et al, evaluated the risks and contraindications of medical compression treatments, including their use in acute DVT 1726 .…”

Section: Alejandro Gonzalezmentioning

confidence: 93%

Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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“…Third, venous foot pumps mimic normal walking by compressing the plantar vein plexus to generate pulsating flow into the veins to increase venous outflow and reduce venous stasis. They have been shown to effectively reduce asymptomatic DVT after orthopedic surgery, but there is no evidence that they can reduce the risk of symptomatic DVT [ 85 ]. Compared with general anesthesia, localized nerve block anesthesia (either via single injection or continuous infusion) of the sympathetic nerve causes vasodilation and reduces the possibility of VTE formations.…”

Section: Management Of Diabetic Footmentioning

confidence: 99%

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)

Wang¹,

Cheng

et al. 2020

Burns &Amp; Trauma

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Abstract In recent years, as living standards have continued to improve, the number of diabetes patients in China, along with the incidence of complications associated with the disease, has been increasing. Among these complications, diabetic foot disease is one of the main causes of disability and death in diabetic patients. Due to the differences in economy, culture, religion and level of medical care available across different regions, preventive and treatment methods and curative results for diabetic foot vary greatly. In multidisciplinary models built around diabetic foot, the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology. In 2019, under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society, the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition) was established with the participation of scholars from the specialist areas of endocrinology, burn injury, vascular surgery, orthopedics, foot and ankle surgery and cardiology. Drawing lessons from diabetic foot guidelines from other countries, this guide analyses clinical practices for diabetic foot, queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China. This paper begins with assessments and diagnoses of diabetic foot, then describes treatments for diabetic foot in detail, and ends with protections for high-risk feet and the prevention of ulcers. This manuscript covers the disciplines of internal medicine, surgical, nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.

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Does intermittent pneumatic compression increase the risk of pulmonary embolism in deep venous thrombosis after joint surgery?

Cited by 6 publications

References 27 publications

What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?

What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?

Recommendations from the ICM-VTE: General

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)

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