Incidence and risk factors for development of venous thromboembolism in Indian patients undergoing major orthopaedic surgery: results of a prospective study

Bagaria, Vaibhav; Modi, N; Panghate, Atul; Vaidya, Satish

doi:10.1136/pgmj.2005.034512

Cited by 82 publications

(98 citation statements)

References 52 publications

(22 reference statements)

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“…3,5,[15][16][17] Studies in Pakistan to asses the frequency of DVT in high-risk surgical patients without thromboprophylaxis revealed an incidence ranging from 0 to 12.8%. 6,18,19 Similarly, studies conducted in neighboring India to asses the risk of DVT in patients undergoing hip and knee arthroplasties reported the incidence of DVT to be 6.1% (Bagaria et al 4 ) and 2.8% ( Jain et al 20 ), respectively, which is significantly lower than the incidence in the West. 8,9 In our study, DVT was found to be more common in patients who had complete SCI and were immobilized for a longer period of time than the patients having incomplete injury or no neurological deficit and who were mobilized earlier.…”

Section: Discussionmentioning

confidence: 98%

“…14 Patients with an SCI are traditionally felt to be at a high risk for developing DVT. 4,6,15 The importance of DVT is in the possibility of pulmonary embolism, which may prove fatal, and chronic venous insufficiency in the long term.…”

Section: Discussionmentioning

confidence: 99%

“…These include activated protein C resistance, an increase in the inhibitor of plasminogen activator-1, hyper-homocysteinemia or a lower prevalence of factor V leiden mutation, which is more common in the western population. 4,5,26 Obesity and heart failure are acquired traits that are thought to be risk factors for development of DVT and have been found to be less prevalent in Asians. 4,5 Both of these factors were absent in our study group.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,26 Obesity and heart failure are acquired traits that are thought to be risk factors for development of DVT and have been found to be less prevalent in Asians. 4,5 Both of these factors were absent in our study group. Another possible explanation could be that soon/immediately after admission, patients received three times a day passive range of motion exercises and massage of lower limbs.…”

Section: Discussionmentioning

confidence: 99%

“…2 In comparison, the incidence of DVT in Asian population is believed to be lower, with an incidence of 1.3-6.1%. [3][4][5][6] Because of the perceived lower risk for DVT compared to Western populations, the routine use of thromboprophylaxis in patients undergoing major surgical procedures is not an established practice in Pakistan. 6 Spinal cord injury (SCI) is a strong risk factor for the development of venous thromboembolism.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

et al. 2008

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Study design: Prospective observational study. Objectives: To assess the prevalence of symptomatic deep vein thrombosis (DVT) in earthquake survivors with spinal cord injury (SCI). Settings: Rawalpindi, Pakistan, in the months after the October 2005 earthquake. Methods: Earthquake survivors (n ¼ 187) with acute SCI were enrolled after verbal informed consent. Information on mechanism of injury, mode of evacuation, associated injuries was gathered, and a detailed clinical and radiological assessment was performed. They were followed for 10 weeks for clinical signs and symptoms suggestive of DVT. Case with clinical suspicion of a DVT underwent a duplex scan of both legs to confirm the diagnosis. The influence of age, gender, American Spinal Injury Association (ASIA) grade and lower limb fractures on occurrence of DVT was determined. Results: There were 80 men and 107 women with a mean age of 28.3 ± 12.4 years. Seventeen patients were clinically suspected to have a DVT and ultrasound was positive in nine (4.8%). There was no influence of age (P ¼ 0.4), gender (P ¼ 0.4), ASIA grade (P ¼ 0.1) or presence of a lower limb fracture (P ¼ 0.6) on the occurrence of a DVT. Conclusion: This study adds further evidence to support the belief that the incidence of DVT in Southeast Asian patients with an SCI is lower than the reported incidence in the West. It may not be necessary to apply the recommendations for DVT prophylaxis in Caucasians with SCI to other groups, including Southeast Asians.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

et al. 2008

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Systematic review and meta-analysis on the rate of postoperative venous thromboembolism in orthopaedic surgery in Asian patients without thromboprophylaxis

Kanchanabat

Stapanavatr

Meknavin

et al. 2011

British Journal of Surgery

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Deep Venous Thrombosis and Pulmonary Embolism are Uncommon in East Asian Patients after Total Hip Arthroplasty

Kang

Lee

Kim

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background In Western countries, deep vein thrombosis (DVT) and pulmonary embolism (PE), are relatively common after THA and many surgeons recommend routine pharmacologic thromboprophylaxis. There is some suggestion in the literature that the incidences of DVT and PE may be lower in East Asian patients. Therefore, it would be important to establish the incidences in a large number of East Asian patients who did not receive pharmacologic thromboprophylaxis.Purpose We therefore determined the incidence of DVT and PE and evaluated the associated risk factors in a series of East Asian patients who underwent primary THA without pharmacologic prophylaxis. Methods We retrospectively evaluated all 861 patients who underwent 992 elective primary THAs from May 2003 to December 2009. We identified patients with symptomatic DVT, symptomatic PE, and fatal PE. For potential risk factors we considered age, gender, body mass index (BMI), administration of aspirin, type of anesthesia, operation time, approach, simultaneous bilateral THAs, and duration of immobilization between symptomatic and asymptomatic patients. Results We identified eight patients with symptomatic DVT, one of whom also had a symptomatic PE; there were no cases of fatal PE. The incidences of fatal PE, symptomatic PE, and symptomatic DVT were 0 %, 0

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Incidence and risk factors for development of venous thromboembolism in Indian patients undergoing major orthopaedic surgery: results of a prospective study

Abstract: The study reconfirms the belief that DVT has a lower incidence in Indian patients as compared with other ethnic groups.

Cited by 82 publications

References 52 publications

The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

The prevalence of deep vein thrombosis in a cohort of patients with spinal cord injury following the Pakistan earthquake of October 2005

Systematic review and meta-analysis on the rate of postoperative venous thromboembolism in orthopaedic surgery in Asian patients without thromboprophylaxis

Deep Venous Thrombosis and Pulmonary Embolism are Uncommon in East Asian Patients after Total Hip Arthroplasty

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