Incidence and Clinical Characteristics of Deep Vein Thrombosis (DVT) after Total Knee Arthroplasty (TKA) with DVT Chemoprophylaxis

Won, Yong Sung; Kim, Mi-Hyeong; Jun, Kang Woong; Nam, Woo Seok; Ahn, Sanghyun; Hwang, Ji-Yeon; Kim, Sang‐Dong; Park, Sun Cheol; Yun, Sang Seob; Lee, Won‐Chul; Park, Jang-Sang; Kim, Jang Yong

doi:10.4236/wjcd.2014.411064

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Here the ratio of symptomatic to asymptomatic DVT is 3(0.56%): 5 (0.94%). 15 Data of 23,475 TKA patients (837 citation of 47 studies were included) conducted across from January 1st, 1996 to September 30th, 2011 (collected across Medline, Embase and Cochrane library), shows symptomatic VTE occurred in 288 patients (incidence 1.2%) and pulmonary embolism in 182 patients (incidence 0.78%). All the patients in the study were on chemoprophylaxis.…”

Section: Discussionmentioning

confidence: 99%

The incidence of symptomatic deep vein thrombosis and pulmonary embolism in the Indian population, following TKA patients, with postoperative prophylaxis

Avulapati¹,

Mahalingam²,

Gudaru³

et al. 2020

IJOS

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Introduction: Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) are the life-threatening complications which can occur in patients undergoing elective Total Knee Arthroplasties (TKA). Incidence in western population appears high in published Literature. While the Indian population it appears to be variable. The difference might be due to different Genetic makeup, social lifestyles of both populations. 1 The study intends to find an incidence of symptomatic DVT and PE in postoperative TKA patients on the prophylactic drug regimen. Aim: To study the incidence of symptomatic DVT and PE, in post-TKA patients in Indian population. Materials and Methods: Retrospective Study conducted from 1 st may, 2017 to 1st may 2018 in BIRRD (T) Hospital. All patients who underwent TKA are included, after following inclusion and exclusion criteria. These patients were evaluated for symptoms during the hospital stay and after discharge for 3 Months. Result: Total number of patients who had TKA were 2292(N=2292). The symptomatic DVT was found in 6(n=6) patients. All 3 patients were managed with a therapeutic regimen. Four patients developed PE (p=4) during the study period, three patients developed pulmonary embolism in first 24 hours postoperatively and expired in spite of ICU management. One patient expired on the 4 th -week postoperatively, with PE at home. Two patients presented with symptoms on 2 nd and 4 th postoperative days, one underwent fasciotomy on 4 th postoperative day. All other patients were on a prophylactic regimen. Conclusion: Our results suggest incidence of DVT and PE are low in the Indian population with a prophylactic regimen.

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Section: Discussionmentioning

confidence: 99%

The incidence of symptomatic deep vein thrombosis and pulmonary embolism in the Indian population, following TKA patients, with postoperative prophylaxis

Avulapati¹,

Mahalingam²,

Gudaru³

et al. 2020

IJOS

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“…All TKA surgeries were performed under a tourniquet. All patients received subcutaneous injection Dalteparin 5000 IU once daily for 14 days in TKA and 35 days in THA patients as postoperative thromboprophylaxis [18]. All patients were given mechanical thromboprophylaxis in the form of compression socks and pneumatic compression devices postoperatively.…”

Section: Preoperative Investigationsmentioning

confidence: 99%

Correlation of Preoperative D-Dimer Levels and Postoperative Venous Thromboembolism in Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty

Agarwala¹,

Vijayvargiya²,

Mishra³

2021

OJO

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Background: The relationship of preoperative D-dimer and Venous thromboembolism (VTE) after total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains controversial. The purpose of this study was to assess the value of D-dimer in the detection of early VTE after TKA and THA. Materials and Methods: A total of 312 patients were evaluated in this retrospective study from 2016 to 2020 at a tertiary care centre, Mumbai who were operated for THA and TKA. The measurement of plasma D-dimer level was done preoperatively and clinically symptomatic patients were evaluated and confirmed for VTE by Colour Doppler Sonography. The plasma D-dimer levels were correlated statistically with the sonographic VTE. Results: 11 patients developed Deep Vein Thrombosis (DVT) and 1 patient developed Pulmonary embolism (PE). Preoperative plasma D-dimer levels were significantly higher (P < 0.01) in patients who developed DVT postoperatively. Colour Doppler Sonography showed that 2 thrombi were seen in proximal veins (pelvic and femoral veins), and 2 thrombi were seen in distal veins (posterior tibial, peroneal, gastrocnemian veins) of the calf in THA patients, and all 8 thrombi were seen in the distal veins (posterior tibial, peroneal, gastrocnemian veins) of the calf in TKA patients. Conclusion: We infer that if the preoperative D-dimer levels were more than 0.5 mg/l, the chances of developing VTE postoperatively are more, which can be diagnosed clinically and further by other investigations. In this study, we have shown that doing preoperative D-dimer level can almost PREDICT the development of VTE and thus prevent complications.

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“…Venous thromboembolism (VTE) has been a concern for orthopedists for a long period of time [5][6][7]. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE), which are characterized by high incidence, high mortality, and high morbidity [8,9]. In clinical practice, VTE can cause serious and potentially fatal complications and lead to fatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prediction of the Risk of Preoperative Deep Vein Thrombosis in Non-fractured Patients Awaiting Total Joint Arthroplasty Using a Support Vector Machine

Wang

Fan²,

Chen

et al. 2021

Preprint

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Background: We developed a potential useful alternative prediction model based on the support vector machine (SAM) algorithm to predict the risk of preoperative deep vein thrombosis (DVT) in non-fractured patients awaiting total joint arthroplasty (TJA). Methods: From March 2015 to August 2020, a retrospective review of the preoperative ultrasound examination findings of lower extremity venous vessels was performed on non-fractured patients of 369 elective TJA. Based on the ultrasound examination findings of preoperative lower extremely venous vessels, these patients were divided into two groups: the DVT group and the Non-DVT group. We collected the clinical, imaging, and laboratory findings from an electronic medical record system. These variables were imported into univariate, multivariate and logistic regression analysis to identify the risk factor for preoperative DVT. According to published literature and clinical experience, a series of variables were selected to construct a prediction model based on the SVM machine learning algorithm. Results: Among the 369 patients, preoperative DVT was observed in 21 patients (5.7%). The Multivariate regression analysis showed the following 5 independent factors associated with preoperative DVT: preoperative fibrinogen odds ratio [OR] = 7.306), age (OR = 1.133), history of hypertension (OR = 3.848), preoperative hematocrit (OR = 0.315), and D-dimer (OR = 2.032). The SVM model achieved a maximum and average area under the receiver operating characteristic curve (AUC) of 0.94 and 0.77 in the 10-fold cross-validation. Meanwhile, the accuracy, precision, and recall of the model were 0.98, 0.92, and 0.93, respectively. Additionally, the confusion matrix showed the classification results of the discriminant analysis.Conclusions: SVM machine modeling is a promising method for the prediction of the risk of DVT in non-fractured patients awaiting TJA. However, future external validation is needed.

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Incidence and Clinical Characteristics of Deep Vein Thrombosis (DVT) after Total Knee Arthroplasty (TKA) with DVT Chemoprophylaxis

Cited by 5 publications

References 27 publications

The incidence of symptomatic deep vein thrombosis and pulmonary embolism in the Indian population, following TKA patients, with postoperative prophylaxis

The incidence of symptomatic deep vein thrombosis and pulmonary embolism in the Indian population, following TKA patients, with postoperative prophylaxis

Correlation of Preoperative D-Dimer Levels and Postoperative Venous Thromboembolism in Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty

Prediction of the Risk of Preoperative Deep Vein Thrombosis in Non-fractured Patients Awaiting Total Joint Arthroplasty Using a Support Vector Machine

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