Risk Factors for Postoperative Deep Venous Thrombosis and Pulmonary Embolism Following Primary Total Hip Arthroplasty and Primary Total Knee Arthroplasty.

Catherine Raquel, Michael Zebold, Michael Foy, Anshum Sood, Mark Gonzalez
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Abstract

Pulmonary embolism (PE) and deep vein thrombosis (DVT) are common postoperative complications. This study retrospectively analyzes preoperative attributes as risk factors for DVT or PE following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Preoperative transfusion, age 65+, dyspnea with moderate exertion, body mass index (BMI) 24.9+ were independent risk factors for PE following THA. Cardiac comorbidities were related with reduced risk. Bleeding disorder, operative time > 110 minutes, perioperative transfusion, age 65+, dyspnea at rest, and BMI < 18.5 were independent risk factors for DVT following THA. Perioperative transfusion, age 57+, dyspnea at rest and with moderate exertion, and BMI 24.9+ were independent risk factors for PE following TKA. Smoking status was related to reduced risk. Perioperative transfusion, age 65+, dyspnea with moderate exertion, and male sex were independent risk factors for DVT following TKA. Cardiac comorbidities were related with reduced risk. Identifying risk factors helps prevent DVT and PE after THA or TKA. (Journal of Surgical Orthopaedic Advances 33(3):138-142, 2024).

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原发性全髋关节置换术和原发性全膝关节置换术术后深静脉血栓形成和肺栓塞的风险因素。
肺栓塞(PE)和深静脉血栓形成(DVT)是常见的术后并发症。本研究回顾性分析了初级全髋关节置换术(THA)和全膝关节置换术(TKA)术前作为深静脉血栓或肺栓塞风险因素的属性。术前输血、65 岁以上、中度用力呼吸困难、体重指数 (BMI) 24.9 以上是 THA 术后发生 PE 的独立风险因素。心脏病合并症与风险降低有关。出血障碍、手术时间大于 110 分钟、围手术期输血、年龄大于 65 岁、休息时呼吸困难和体重指数小于 18.5 是 THA 术后深静脉血栓形成的独立风险因素。TKA术后发生PE的独立风险因素包括围手术期输血、57岁以上、静息时和中度用力时呼吸困难以及体重指数24.9以上。吸烟与风险降低有关。围手术期输血、65 岁以上、中度劳累时呼吸困难和男性是 TKA 术后深静脉血栓形成的独立风险因素。心脏病合并症与风险降低有关。识别风险因素有助于预防THA或TKA术后深静脉血栓形成和PE。(外科骨科进展杂志》33(3):138-142,2024)。
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