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

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

doi:10.1007/s00167-018-5253-3

Cited by 24 publications

(24 citation statements)

References 27 publications

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“…Studies have shown that reasonable use of anticoagulants can effectively reduce the incidence of VTE after hip and knee arthroplasty (38)(39)(40). However, inappropriate use of anticoagulants can increase the incidence of adverse events, such as infection, poor wound healing, and increased blood loss (27,41,42).…”

Section: Discussionmentioning

confidence: 99%

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

Chen¹,

Ma²,

Li³

et al. 2020

Ann Palliat Med

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Background: As Asian populations, Chinese have a lower rate of high-risk gene mutations in venous thrombosis. Therefore, individual patient risk assessment, rather than a "blanket policy", is considered the best thromboembolism prophylaxis for Chinese. The purpose of this study was to evaluate the effectiveness and safety of selective thromboembolism prophylaxis compared with conventional thromboembolism prophylaxis by risk stratification with thromboelastography (TEG) after joint arthroplasty in Chinese.Methods: Between August 2016 to August 2017, Chinese patients who underwent hip or knee arthroplasty were randomly divided into a selective anticoagulation group (SAG) and a conventional anticoagulation group (CAG). Participants and outcome assessors were blinded. In the SAG, an anticoagulant was used when TEG indicated hypercoagulability; while in the CAG, an anticoagulant was regularly used until one month after surgery. Outcome evaluation included effectiveness (defined as the incidence of VTE), and safety (defined as the incidence of bleeding events, poor wound healing, blood loss, and infection).Results: A total of 197 patients (79 in the SAG and 118 in the CAG) were included in the study. There was 1 case of deep vein thrombosis (DVT) in the SAG and 2 cases of DVT in the CAG, but there was no significant difference between the two groups. Hidden blood loss in the SAG was 707.4±539.8 mL and hidden blood loss in the CAG was 617±565.0 mL, respectively (P>0.05). No significant difference was observed in perioperative blood loss between the SAG and the CAG (1,024.9±597.9 and 1,139.3±620.9 mL, respectively). Volume of blood transfusion was 92.4±270.2 mL in the SAG and 224.6±416.3 mL in the CAG, respectively, while rate of transfusion was 13.9% in the SAG and 33.9% in the CAG, respectively, which were significantly different between the two groups (P<0.05). Conclusions:In Chinese patients who underwent hip or knee arthroplasty, the efficacy of selective anticoagulation using TEG in risk stratification was comparable to that of conventional anticoagulation. Furthermore, the safety of selective anticoagulant prophylaxis was superior to that of conventional anticoagulant prophylaxis.

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Section: Discussionmentioning

confidence: 99%

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

Chen¹,

Ma²,

Li³

et al. 2020

Ann Palliat Med

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“…The rate of DVT after AKO was almost the intermediate value between TKA and ACLR; thus, our hypothesis was confirmed. The incidence of symptomatic VTEs in Asian regions is low in comparison to studies targeting Western populations [5].…”

Section: Discussionmentioning

confidence: 80%

Perioperative pain control is important for prevention of venous thromboembolism after around the knee osteotomy

Kubota¹,

Kim²,

Sato³

et al. 2020

Preprint

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Background: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) are well-known complications after TKA. However, there are few reports about VTEs after around the knee osteotomy (AKO). Purpose: To investigate the incidence of and risk factors for VTEs after AKO. Methods: A total 108 AKO cases were assessed in this study. The procedures included open-wedge high tibial osteotomy (OWHTO; n=96), hybrid closed-wedge high tibial osteotomy (CWHTO; n=7), distal femoral osteotomy (DFO; n=2), tibial condylar valgus osteotomy (TCVO; n=2), and double level osteotomy (DLO; n=1). Ultrasonography of the lower extremities was performed for all patients at 1 week after AKO. The incidence of VTEs was investigated, and a logistic regression analysis was performed to determine which patient demographics, pre-operative clinical results and surgical factors were associated with DVT or PE after surgery. Results: Of the 108 patients who underwent AKO, 29 (26.9%) developed postoperative DVT, but no patients developed PE. The logistic regression analysis identified abrasion chondroplasty (odds ratio [OR], 3.46) and pre-operative pain visual analog scale (VAS; OR, 1.05) as independent predictors of DVT. Conclusion: The incidence of DVT after AKO is relatively high and preoperative and postoperative pain may induce DVT. Perioperative pain control is important for preventing VTEs.

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“…Lee et al used the Korean National Health Insurance (NHI) claims database in 2010 to show a 90-day VTE rate of 3.8% (DVT 3.2%, PE 0.7%), which may be significantly higher than other studies because the rate of chemoprophylaxis was only 48.4% [ 40 ]. Zeng et al studied 78 hospitals in Asia between 2013–2016 and found an in-hospital DVT rate of 0.36%, which is much lower than rates in other studies [ 44 ].…”

Section: Rates Of Vte After Total Hip and Knee Arthroplastymentioning

confidence: 82%

“…Fuji et al used an administrative database of Japanese patients between 2008 and 2013, and found an overall VTE rate of 0.9% (DVT 0.9%, PE 0.2%) [ 43 ]. Zeng et al studied 78 hospitals in Asia between 2013–2016 and found an in-hospital DVT rate of 0.21% [ 44 ].…”

Section: Rates Of Vte After Total Hip and Knee Arthroplastymentioning

confidence: 99%

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An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020

et al. 2020

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Patients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6–1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute number of patients. The rate of VTE after total hip arthroplasty has been stable over the past decade, although there has been a slight reduction in the rate of deep venous thrombosis (DVT), but not pulmonary embolism (PE), after total knee arthroplasty. Over this time, there has been significant research into the optimal choice of pharmacologic VTE prophylaxis for individual patients, with the objective to reduce the rate of VTE while minimizing adverse side effects such as bleeding. Recently, aspirin has emerged as a promising prophylactic agent for patients undergoing arthroplasty due to its similar efficacy and good safety profile compared to other pharmacologic agents. However, there is no evidence to date that clearly demonstrates the superiority of any given prophylactic agent. Therefore, this review discusses (1) the current prevalence and trends in VTE after total hip and knee arthroplasty and (2) provides an update on pharmacologic VTE prophylaxis in regard to aspirin usage.

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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

Cited by 24 publications

References 27 publications

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

Perioperative pain control is important for prevention of venous thromboembolism after around the knee osteotomy

An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020

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