Prevalence of Venous Thromboembolic Events Is Low in Asians After Total Knee Arthroplasty Without Chemoprophylaxis

被引:23
作者
Bin Abd Razak, Hamid Rahmatullah [1 ]
Abd Razak, Noorul Faeyza Binte [2 ]
Tan, Hwee-Chye Andrew [1 ]
机构
[1] Singapore Gen Hosp, Dept Orthopaed Surg, 20 Coll Rd,Acad Level 4, Singapore 169865, Singapore
[2] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore
关键词
total knee arthroplasty; Asian; VTE; complications; prevalence; chemoprophylaxis; DEEP-VEIN THROMBOSIS; FACTOR-V-LEIDEN; FATAL PULMONARY-EMBOLISM; REPLACEMENT; RISK; METAANALYSIS; PROPHYLAXIS; CALF; HIP; ANTICOAGULATION;
D O I
10.1016/j.arth.2016.09.008
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: This retrospective cohort study was designed to establish the prevalence of clinically significant venous thromboembolic events (VTE) in our patients undergoing total knee arthroplasty (TKA) without chemoprophylaxis. Methods: A single-surgeon cohort of patients who underwent TKA from 2006 to 2014 were included. All patients had a pneumatic tourniquet applied and a drain inserted postoperatively. Tranexamic acid was not used perioperatively. All patients were under a standardized postoperative protocol with routine mechanical prophylaxis against VTE. None of the patients received prophylactic anticoagulation. All patients ambulated on the second postoperative day. Only symptomatic patients were referred for radiological examination to exclude VTE. We evaluated the patient demographics and calculated the prevalence of VTE in our cohort. Results: A total of 966 patients were reviewed. Mean age was 66.1 +/- 7.8 years. Mean body mass index was 28.2 +/- 4.7 kg/m(2). Mean tourniquet time was 53 +/- 23 minutes. Patients stayed in hospital for a mean of 5.4 +/- 3.1 days. There was 100% compliance to mechanical prophylaxis. And 11.1% of our patients were on concomitant antiplatelet or anticoagulant use. There were 8 patients with clinically significant VTE. This translates to a prevalence of 0.82%. Seven patients developed deep vein thrombosis and 1 patient died from massive pulmonary embolism. Conclusion: The prevalence of clinically significant VTE in our patients who underwent TKA without routine chemoprophylaxis is 0.82%. With proper patient selection, risk stratification, and stringent perioperative protocols, routine chemoprophylaxis may not be necessary in Asians undergoing TKA. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:974 / 979
页数:6
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