Venous thromboembolism complications in shoulder surgery: current concepts

Mancini, Michael R.; LeVasseur, Matthew R.; Hawthorne, Benjamin C.; Marrero, Daniel E.; Mazzocca, Augustus D.

doi:10.1136/jisakos-2020-000538

Cited by 5 publications

(9 citation statements)

References 64 publications

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“…Notably, a prior retrospective review performed by Schick et al 45 demonstrated that venous thromboembolism uncommonly occurs at a rate of 0.15% following shoulder arthroscopy. Thus, while the data demonstrate that the risk of DVT is low for stabilization procedures, 20 , 30 , 45 the resulting effect can be detrimental and health-care providers should be aware of the risk when undergoing surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Comparison of perioperative complications following surgical treatment of shoulder instability

Eberlin¹,

Varady²,

Kucharik³

et al. 2022

JSES International

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Section: Discussionmentioning

confidence: 99%

Comparison of perioperative complications following surgical treatment of shoulder instability

Eberlin¹,

Varady²,

Kucharik³

et al. 2022

JSES International

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“…On the basis of the original prevention plan, Shanghai Changhai Hospital revised the new version of VTE prevention guidelines [23]. Some scholars formulated the SOP for orthopedic DVT prevention based on Caprini risk assessment [24], which provided a reference for unifying the standard, but its clinical practicality still needed to be further explored. rough literature analysis and Delphi method, this study developed a scientific, standardized, reasonable, effective, and practical SOP for VTE prevention, with the main methods of learning from the key points of the domestic and foreign literature, combining with nursing experience, strengthening prevention management, training and education, and improving VTE assessment methods, so as to lower the incidence and mortality of VTE.…”

Section: Discussionmentioning

confidence: 99%

Application Effect of the Standard Operating Procedure in the Prevention of Venous Thromboembolism

Zhang

Zhu

Wang

et al. 2022

Journal of Healthcare Engineering

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Objective. To investigate the application effect of the standard operating procedure (SOP) in the prevention of venous thromboembolism (VTE). Methods. The clinical data of patients admitted to respiratory, cardiovascular, neurological, and geriatric departments in the hospital (November 2020–May 2021) were retrospectively analyzed, and the patients in line with the inclusion criteria were equally randomized into the observation group (OG) and the control group (CG). The CG was treated with the routine nursing, and the OG received the SOP of VTE prevention additionally. After the record of the incidence of VTE and nursing satisfaction of the two groups, scores of VTE awareness were compared. Results. One hundred and twenty patients were included in this study, and no obvious difference was found in the general data of patients ( P > 0.05). Compared with the CG, the incidence of VTE of the OG was obviously lower ( P < 0.05). After nursing, compared with the CG, scores of VTE awareness in the OG were conspicuously higher ( P < 0.001), and scores of VTE awareness of the nursing staff were conspicuously higher than those before nursing ( P < 0.001). Compared with the CG, nursing satisfaction of the OG was obviously higher ( P < 0.001). Conclusion. SOP can reduce the incidence of VTE of patients, improve their disease awareness, and enhance their nursing satisfaction, which should be popularized in practice.

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“…Venous thromboembolism is a rare but potentially devastating complication of TSA, with substantial im-plications for cost of care, morbidity, and mortality. 5,6 Owing to the uncommon nature of this complication, risk factors have not been well defined, and Clinical Practice Guidelines for VTE prevention after TSA rely heavily on the risk stratification of individual patients. In 2009, the American Academy of Orthopaedic Surgeons published Clinical Practice Guidelines on the Treatment of Glenohumeral Osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a rare but serious complication of orthopaedic surgery that may entail hospital admission, anticoagulation therapy, cardiopulmonary morbidity, and even death. 5,6 The incidence of symptomatic VTE after lower extremity orthopaedic surgery has been well described; 7 moreover, the rates of VTE after lower extremity orthopaedic surgery have been shown to decrease from 40% to 60% in an untreated population to approximately 1.8% for DVT and 1% for PE in patients treated with VTE chemoprophylaxis. 7,8 Although established guidelines for the use of chemoprophylaxis after lower extremity arthroplasty are in place, no definitive guidelines exist for shoulder arthroplasty.…”

mentioning

confidence: 99%

Venous Thromboembolism After Total Shoulder Arthroplasty: A Database Study of 31,918 Cases

Zhang

Dyer

Earp

2022

J Am Acad Orthop Surg

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Introduction: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a rare but serious complication of total shoulder arthroplasty (TSA). Owing to limited evidence, Clinical Practice Guideline recommendations for VTE chemoprophylaxis after TSA rely heavily on the risk stratification of individual patients. The objectives of this study were to identify the prevalence and risk factors independently associated with VTE, PE, and DVT in the 30-day postoperative period after TSA. Methods: A retrospective case-control study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database by querying the Current Procedural Terminology code for total shoulder arthroplasty from 2011 to 2020. The initial query resulted in 33,089 patients. After applying exclusion criteria for age younger than 50 years, emergency surgery, and open wound or infection, a final cohort of 31,918 patients who underwent TSA were included. The primary outcome was venous thromboembolism, and secondary outcome variables were PE and DVT. A bivariate screen was done for explanatory variables associated with our outcome variables, and variables with P , 0.1 in the bivariate screen were included in a multivariable logistic regression model. Results: Of the 31,918 patients in our cohort, 183 patients (0.573%) developed VTE, 92 patients (0.29%) developed PE, and 104 patients (0.326%) developed DVT during the 30-day postoperative period. Multivariable logistic regression analysis showed that older age, higher body mass index, longer surgical time, and longer hospital length of stay were associated with VTE and PE and that hypertension and shorter hospital length of stay were associated with DVT. Discussion: The prevalence of VTE after TSA is low. Older patients, patients with higher body mass index, and patients with longer surgical durations are at higher risk for VTE after TSA. Our findings are relevant for preoperative risk stratification and the decision for chemoprophylaxis.

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Venous thromboembolism complications in shoulder surgery: current concepts

Cited by 5 publications

References 64 publications

Comparison of perioperative complications following surgical treatment of shoulder instability

Comparison of perioperative complications following surgical treatment of shoulder instability

Application Effect of the Standard Operating Procedure in the Prevention of Venous Thromboembolism

Venous Thromboembolism After Total Shoulder Arthroplasty: A Database Study of 31,918 Cases

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