Jitendra Mangwani, Linzy Houchen-Wolloff, Karan Malhotra, Sarah Booth, Aiden Smith, Lucy Teece, Lyndon W Mason, Rabia Shaikh, Wilam Alfred, Imobhio Okhifun, Ece Cinar, Nelson Bua, Krishna Vemulapalli, Ashok Acharya, Richard Gadd, John Money-Taylor, Rohit Kantharaju, Abhijit Bhosale, Suchita Bahri, Rosie Broadbent, Isabella Drummond, Neil Jones, Savan Shah, Thuwarahan Ravindrarjah, Zaid Yasen, Kunjshri Singh, Ruqaiya Al-Habs, Lucky Jeyaseelan, Abdullah Habbiba, Thomas Walker, Maximilian Dewhurst, Nisha Glasgow, Dominic Eze, Gary Carter, Praveen Rajan, Vijay Patil, Omer Amer, Kalim Malik, Pranavan Pavanerathan, Arijit Mallick, Ilias Seferiadis, Verity Currall, Preetha Sadasivan, Sunil Kumar, Shahrukh R Sanjani, Maria Ciaccio, Brijesh Ayyaswamy, Pradeepsyam Prasad, Mr Anand, Dr Sunilraj, Suzanne Lane, Swetha Prathap, Raghubir Kankate, Ioannis Aktselis, Kinner Davda, Arvind Vijapur, Mohammed Tayyem, Jackie Chau, Muhammad S Azhar, Simon Sturdee, Halima Hussain, Sarah Sonde, Muhammad Q Luqman, Rahy Farooq, Gareth Wells, Aneil Shenolikar, Michiel Simons, Paul Hodgson, Rhys Thomas, Sam Stevens, Yahya Elhassan, Adebowale Adeniyi, Will Aspinall, Vinay Joseph, Miriam Day, Aureola Tong, Claire Joyner, Muhammed Alzaranky, Osman Elhassan, Kishor Chhantyal, Abhishek Arora, Zain Abiddin, Robert Kucharski, Irfan Ahmad, Junaid Zeb, Usman Ishaq, Jija Thomas, Kowshik Jain, Rupinderbir Deol, Rad Faroug, Karan Johal, Simon Mordecai, Miltiadis Argyropouos, Amit Chawla, Mohamed Ibrahim, Marta Pereira, Lynne Barr, Elda Julies, Francesca Hill, Smriti Kapoor, James Bailey, Ishani Mukhopadhyay, Sarina Rana, Hamza Tarig, Mahdi Qualaghassi, Sheena Seewoonarian, Barry Rose, Georgina Crate, Sarah Abbott, Christopher Fenner, Ryan Geleit, Sohail Yousaf, Nimra Akram, Zahra Al-Hubeshy, Bhavi Patel, Mohamed Hussein, Callum Clark, Jasdeep Giddie, Raman Dega, Kishore Dasari, Gurbinder Nandhara, Pritesh Kumar, Prateek Gupta, Hope Poole, Pamela Zace, Farhan Alvi, Jagan Jacob, Raji Reddy, Vaishnav Sateesh, Andrea Gledhill, James Craven, Matt Cichero, Ben Yates, Ayla Newton, John Grice, Nicholas Fawcett, Hossam Fraig, Farouk Hamad, Daniel Marsland, Robin Elliot, Yaser Ghani, Suresh Chandrashekhar, Ravi K Millan, Andrew Clark, Kashed Rahman, Mark Sykes, Zoe Little, Jawaad Saleem, Lewis Jolly, Aman Jain, Ansar Qadri, Sophy Rymaruk, Avadhut Kulkarni, Mohanrao Garabadi, Meraj Akhtar, Munier Hossain, Shamael Yunus, Maleeha Saleem, Joanna Fong, Amirul Islam, Ben Nusir, James Chapman, David Holmes, Neville Mamoowala, Kieran Almond, Claire Wright, Ethan Caruana, Thomas Watson, Georgia Allison, Anand Pillai, Imad Madhi, Mazin Alsalihy, Khadija Elamin, Chee Rong Yip, Lucy Tew, Rohan Dahiya, Thomas Goff, Oliver Bagshaw, Henry Slade, Paul Andrzejowski, Ayoub Gomati, Chris Drake, Jamie Hind, Rebecca Morgan, Ahmed Khalaf, Adeel Ditta, Arul Ramasamy, Joshua McIntyre, Calum Blacklock, Scott Middleton, Robert Clayton, Alex Hrycaiczuk, Christopher Thornhill, Gowsikan Jeyakumar, Delani Vaithilingam, Kate Potter, Bilal Jamal/Pete Chan, Muyed Mohamed, Debbie Fraser, Ahmed Elhalawany, James Beastall, Gerard Cousins, Perrico Nunag, David Loveday, Akshdeep Bawa, Rebecca Gilmore, Kerstin Schankat, Andrew Walls, Nicole Corin, Peter Robinson, Steve Hepple, William Harries, Andrew Riddick, Ian Winson, Luke Marsh, Muhammad A Bashir, Jigyasa Saini, Henry Atkinson, Rajiv Limaye, Sarah Johnson-Lynn, Mohit Sethi, George Flanagan, Akram Uddin, Ian Reilly, Rebecca Martin, Andrea Pujol-Nichol, Natalie Carroll, Alexander Boucher, Mustafa Alward, Yuland Myint, Katherine Butler, Adrian Kendal, Mark Bugeja, Justin Mooteeram, Farid Saedi, Togay Koc, Zeid Morcos, Gregory Robertson, Natal Holmes, Howard Tribe, Tim Pearkes, Ahmed Soliman, Anil Prasanna, Kar Teoh, Sanil Kamat, Abhijit Bajracharya, James Reeves, Mbori Ngwayi, Galal Imtiaz, Noah Blackmore, Benjamin Lau, Arjun Naik, Eleanor Tung, Siddhartha Murhekar, Robbie Ray, Shirley Lyle, Nilesh Makwana, Kahlan A Kaisi, Musab Al-Musabi, Mike Dean, Adrian Hughes, Kimberley Shuttlewood, Matthew Welck, Shelain Patel, Adam Sykes, Mahesh M Thibbaiah, Hosain Hadi, Anil Haldar, Amir G Ardakani, Priyanka Jani, Vladislav Kutuzov, James Gibbons, Daniel Trussler, Eve Hawley, Sabeen Akhtar, Harshadkumar D Rajgor, Basil Budair, Hari Prem, James Mckenzie, Daniel Thurston, Michael O'Sullivan, Mohammed Elmajee, Erika Pond, Wajiha Zahra, Catriona Heaver, Kueni Igbagiri, Andrew Gaukroger, Matthew Solan, Christian Peacock, Ka S Fan, Tristan Barton, Derek Robinson, Selina Graham, Julian Zeolla, Samuel Everett, Mohammad Iqbal, Lysander Gourbault, Shashwat Singh, Cary Tang, Mariam Tarhini, Shahrukh Khan, Satishkumar Balasubramanian, Caroline Lever, Vaibhav Bansod, Kartik Iyengar, Abdul Wadood, Lara McMillan, Eugene Toh, Stanley Masunda, Simon Federer, Faheem Ahmad, Ahmed Lashin, Ahmed Kaddah, Emmanuel Oladeji, Ed Dawe, Ciaran Nolan, Khalil El-Bayouk, Vivek Dhukaram, Anna Chapman, Laura Beddard, Alex Thomas, Vipul Garg, Heath Taylor, Nikki Kelsall, Charline Roslee, Nimra Akram, Hamish Lowdon, Ahmed Kamel-Sherif, Anette Jones, Alistair Best, Mate Zabaglo, Junaid Sayani, Olive Kyaw, Chan Khin, Ramla Ali, Yousufuddin Shaik, Natasha Hossain, Lucia Valente, Adam Ajis, Abhijit Guha, Melwyn Pereira, Atif Ayoub, Vlad Paraoan, Nayeem Hali, Charles Baird, Raj Kugan, Ahmad Abdallatif, Mark Blomfield, Gillian Jackson, James Craven, Anubhav Malhotra, Aileen Toner, Luke Render, Connor Ashley, Richard Limb, Robert Smith, Luke Hughes, Hannah Matthews, Fleur Shiers-Gelalis, Jason Ting, Stuart Place, Adam Budgen, James Stanley, Charlie Jowett
{"title":"UK Foot and Ankle Thromboembolism (UK-FATE).","authors":"Jitendra Mangwani, Linzy Houchen-Wolloff, Karan Malhotra, Sarah Booth, Aiden Smith, Lucy Teece, Lyndon W Mason, Rabia Shaikh, Wilam Alfred, Imobhio Okhifun, Ece Cinar, Nelson Bua, Krishna Vemulapalli, Ashok Acharya, Richard Gadd, John Money-Taylor, Rohit Kantharaju, Abhijit Bhosale, Suchita Bahri, Rosie Broadbent, Isabella Drummond, Neil Jones, Savan Shah, Thuwarahan Ravindrarjah, Zaid Yasen, Kunjshri Singh, Ruqaiya Al-Habs, Lucky Jeyaseelan, Abdullah Habbiba, Thomas Walker, Maximilian Dewhurst, Nisha Glasgow, Dominic Eze, Gary Carter, Praveen Rajan, Vijay Patil, Omer Amer, Kalim Malik, Pranavan Pavanerathan, Arijit Mallick, Ilias Seferiadis, Verity Currall, Preetha Sadasivan, Sunil Kumar, Shahrukh R Sanjani, Maria Ciaccio, Brijesh Ayyaswamy, Pradeepsyam Prasad, Mr Anand, Dr Sunilraj, Suzanne Lane, Swetha Prathap, Raghubir Kankate, Ioannis Aktselis, Kinner Davda, Arvind Vijapur, Mohammed Tayyem, Jackie Chau, Muhammad S Azhar, Simon Sturdee, Halima Hussain, Sarah Sonde, Muhammad Q Luqman, Rahy Farooq, Gareth Wells, Aneil Shenolikar, Michiel Simons, Paul Hodgson, Rhys Thomas, Sam Stevens, Yahya Elhassan, Adebowale Adeniyi, Will Aspinall, Vinay Joseph, Miriam Day, Aureola Tong, Claire Joyner, Muhammed Alzaranky, Osman Elhassan, Kishor Chhantyal, Abhishek Arora, Zain Abiddin, Robert Kucharski, Irfan Ahmad, Junaid Zeb, Usman Ishaq, Jija Thomas, Kowshik Jain, Rupinderbir Deol, Rad Faroug, Karan Johal, Simon Mordecai, Miltiadis Argyropouos, Amit Chawla, Mohamed Ibrahim, Marta Pereira, Lynne Barr, Elda Julies, Francesca Hill, Smriti Kapoor, James Bailey, Ishani Mukhopadhyay, Sarina Rana, Hamza Tarig, Mahdi Qualaghassi, Sheena Seewoonarian, Barry Rose, Georgina Crate, Sarah Abbott, Christopher Fenner, Ryan Geleit, Sohail Yousaf, Nimra Akram, Zahra Al-Hubeshy, Bhavi Patel, Mohamed Hussein, Callum Clark, Jasdeep Giddie, Raman Dega, Kishore Dasari, Gurbinder Nandhara, Pritesh Kumar, Prateek Gupta, Hope Poole, Pamela Zace, Farhan Alvi, Jagan Jacob, Raji Reddy, Vaishnav Sateesh, Andrea Gledhill, James Craven, Matt Cichero, Ben Yates, Ayla Newton, John Grice, Nicholas Fawcett, Hossam Fraig, Farouk Hamad, Daniel Marsland, Robin Elliot, Yaser Ghani, Suresh Chandrashekhar, Ravi K Millan, Andrew Clark, Kashed Rahman, Mark Sykes, Zoe Little, Jawaad Saleem, Lewis Jolly, Aman Jain, Ansar Qadri, Sophy Rymaruk, Avadhut Kulkarni, Mohanrao Garabadi, Meraj Akhtar, Munier Hossain, Shamael Yunus, Maleeha Saleem, Joanna Fong, Amirul Islam, Ben Nusir, James Chapman, David Holmes, Neville Mamoowala, Kieran Almond, Claire Wright, Ethan Caruana, Thomas Watson, Georgia Allison, Anand Pillai, Imad Madhi, Mazin Alsalihy, Khadija Elamin, Chee Rong Yip, Lucy Tew, Rohan Dahiya, Thomas Goff, Oliver Bagshaw, Henry Slade, Paul Andrzejowski, Ayoub Gomati, Chris Drake, Jamie Hind, Rebecca Morgan, Ahmed Khalaf, Adeel Ditta, Arul Ramasamy, Joshua McIntyre, Calum Blacklock, Scott Middleton, Robert Clayton, Alex Hrycaiczuk, Christopher Thornhill, Gowsikan Jeyakumar, Delani Vaithilingam, Kate Potter, Bilal Jamal/Pete Chan, Muyed Mohamed, Debbie Fraser, Ahmed Elhalawany, James Beastall, Gerard Cousins, Perrico Nunag, David Loveday, Akshdeep Bawa, Rebecca Gilmore, Kerstin Schankat, Andrew Walls, Nicole Corin, Peter Robinson, Steve Hepple, William Harries, Andrew Riddick, Ian Winson, Luke Marsh, Muhammad A Bashir, Jigyasa Saini, Henry Atkinson, Rajiv Limaye, Sarah Johnson-Lynn, Mohit Sethi, George Flanagan, Akram Uddin, Ian Reilly, Rebecca Martin, Andrea Pujol-Nichol, Natalie Carroll, Alexander Boucher, Mustafa Alward, Yuland Myint, Katherine Butler, Adrian Kendal, Mark Bugeja, Justin Mooteeram, Farid Saedi, Togay Koc, Zeid Morcos, Gregory Robertson, Natal Holmes, Howard Tribe, Tim Pearkes, Ahmed Soliman, Anil Prasanna, Kar Teoh, Sanil Kamat, Abhijit Bajracharya, James Reeves, Mbori Ngwayi, Galal Imtiaz, Noah Blackmore, Benjamin Lau, Arjun Naik, Eleanor Tung, Siddhartha Murhekar, Robbie Ray, Shirley Lyle, Nilesh Makwana, Kahlan A Kaisi, Musab Al-Musabi, Mike Dean, Adrian Hughes, Kimberley Shuttlewood, Matthew Welck, Shelain Patel, Adam Sykes, Mahesh M Thibbaiah, Hosain Hadi, Anil Haldar, Amir G Ardakani, Priyanka Jani, Vladislav Kutuzov, James Gibbons, Daniel Trussler, Eve Hawley, Sabeen Akhtar, Harshadkumar D Rajgor, Basil Budair, Hari Prem, James Mckenzie, Daniel Thurston, Michael O'Sullivan, Mohammed Elmajee, Erika Pond, Wajiha Zahra, Catriona Heaver, Kueni Igbagiri, Andrew Gaukroger, Matthew Solan, Christian Peacock, Ka S Fan, Tristan Barton, Derek Robinson, Selina Graham, Julian Zeolla, Samuel Everett, Mohammad Iqbal, Lysander Gourbault, Shashwat Singh, Cary Tang, Mariam Tarhini, Shahrukh Khan, Satishkumar Balasubramanian, Caroline Lever, Vaibhav Bansod, Kartik Iyengar, Abdul Wadood, Lara McMillan, Eugene Toh, Stanley Masunda, Simon Federer, Faheem Ahmad, Ahmed Lashin, Ahmed Kaddah, Emmanuel Oladeji, Ed Dawe, Ciaran Nolan, Khalil El-Bayouk, Vivek Dhukaram, Anna Chapman, Laura Beddard, Alex Thomas, Vipul Garg, Heath Taylor, Nikki Kelsall, Charline Roslee, Nimra Akram, Hamish Lowdon, Ahmed Kamel-Sherif, Anette Jones, Alistair Best, Mate Zabaglo, Junaid Sayani, Olive Kyaw, Chan Khin, Ramla Ali, Yousufuddin Shaik, Natasha Hossain, Lucia Valente, Adam Ajis, Abhijit Guha, Melwyn Pereira, Atif Ayoub, Vlad Paraoan, Nayeem Hali, Charles Baird, Raj Kugan, Ahmad Abdallatif, Mark Blomfield, Gillian Jackson, James Craven, Anubhav Malhotra, Aileen Toner, Luke Render, Connor Ashley, Richard Limb, Robert Smith, Luke Hughes, Hannah Matthews, Fleur Shiers-Gelalis, Jason Ting, Stuart Place, Adam Budgen, James Stanley, Charlie Jowett","doi":"10.1302/0301-620X.106B11.BJJ-2024-0128.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture. Secondary aims were to assess the variation in the provision of chemical prophylaxis and risk factors for VTE.</p><p><strong>Methods: </strong>This was a multicentre, prospective national collaborative audit with data collection over nine months for all patients undergoing foot and ankle surgery in an operating theatre or TA rupture treatment, within participating UK hospitals. The association between VTE and thromboprophylaxis was assessed with a univariable logistic regression model. A multivariable logistic regression model was used to identify key predictors for the risk of VTE.</p><p><strong>Results: </strong>A total of 13,569 patients were included from 68 sites. Overall, 11,363 patients were available for analysis: 44.79% were elective (n = 5,090), 42.16% were trauma excluding TA ruptures (n = 4,791), 3.50% were acute diabetic procedures (n = 398), 2.44% were TA ruptures undergoing surgery (n = 277), and 7.10% were TA ruptures treated nonoperatively (n = 807). In total, 11 chemical anticoagulants were recorded, with the most common agent being low-molecular-weight heparin (n = 6,303; 56.79%). A total of 32.71% received no chemical prophylaxis. There were 99 cases of VTE (incidence 0.87% (95% CI 0.71 to 1.06)). VTE-related mortality was 0.03% (95% CI 0.005 to 0.080). Univariable analysis showed that increased age and American Society of Anesthesiologists (ASA) grade had higher odds of VTE, as did having previous cancer, stroke, or history of VTE. On multivariable analysis, the strongest predictors for VTE were the type of foot and ankle procedure and ASA grade.</p><p><strong>Conclusion: </strong>The 90-day incidence of symptomatic VTE and mortality related to VTE is low in foot and ankle surgery and TA management. There was notable variability in the chemical prophylaxis used. The significant risk factors associated with 90-day symptomatic VTE were TA rupture and high ASA grade.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"106-B 11","pages":"1249-1256"},"PeriodicalIF":4.9000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.106B11.BJJ-2024-0128.R1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture. Secondary aims were to assess the variation in the provision of chemical prophylaxis and risk factors for VTE.
Methods: This was a multicentre, prospective national collaborative audit with data collection over nine months for all patients undergoing foot and ankle surgery in an operating theatre or TA rupture treatment, within participating UK hospitals. The association between VTE and thromboprophylaxis was assessed with a univariable logistic regression model. A multivariable logistic regression model was used to identify key predictors for the risk of VTE.
Results: A total of 13,569 patients were included from 68 sites. Overall, 11,363 patients were available for analysis: 44.79% were elective (n = 5,090), 42.16% were trauma excluding TA ruptures (n = 4,791), 3.50% were acute diabetic procedures (n = 398), 2.44% were TA ruptures undergoing surgery (n = 277), and 7.10% were TA ruptures treated nonoperatively (n = 807). In total, 11 chemical anticoagulants were recorded, with the most common agent being low-molecular-weight heparin (n = 6,303; 56.79%). A total of 32.71% received no chemical prophylaxis. There were 99 cases of VTE (incidence 0.87% (95% CI 0.71 to 1.06)). VTE-related mortality was 0.03% (95% CI 0.005 to 0.080). Univariable analysis showed that increased age and American Society of Anesthesiologists (ASA) grade had higher odds of VTE, as did having previous cancer, stroke, or history of VTE. On multivariable analysis, the strongest predictors for VTE were the type of foot and ankle procedure and ASA grade.
Conclusion: The 90-day incidence of symptomatic VTE and mortality related to VTE is low in foot and ankle surgery and TA management. There was notable variability in the chemical prophylaxis used. The significant risk factors associated with 90-day symptomatic VTE were TA rupture and high ASA grade.
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