Division of Orthopedic Surgery, University of Toronto, Toronto, ON, Canada.
J Rheumatol. 2009 Oct;36(10):2298-301. doi: 10.3899/jrheum.090282. Epub 2009 Aug 14.
We asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic deep vein thrombosis (DVT) at 3 months followup.
We reviewed 1460 patients from our joint registry undergoing primary, unilateral TKR between 1998-2006. Demographic variables of age, sex, comorbidity, and education were retrieved. Metabolic syndrome was defined as body mass index above 30 kg/m(2), diabetes, hypertension, and hypercholesterolemia. Logistic regression was used to examine the relationship of metabolic syndrome on the incidence of DVT.
The overall incidence of symptomatic DVT was 4.4% (65/1460). Patients with metabolic syndrome had an increased incidence of DVT compared to those without metabolic syndrome (15.5% vs 3.4%). Adjusted analysis showed that the risk of symptomatic DVT in patients with metabolic syndrome was 3.2 times [odds ratio 3.2, 95% CI (1.0,15.4), p = 0.04] the risk in those without metabolic syndrome.
Hospital protocols developed for prophylactic anticoagulation following TKR should give special consideration to patients with metabolic syndrome.
我们研究了代谢综合征患者在全膝关节置换术后 3 个月时发生症状性深静脉血栓（DVT）的风险是否增加。
我们回顾了我们关节登记处 1998 年至 2006 年间接受初次单侧全膝关节置换术的 1460 例患者。检索了年龄、性别、合并症和教育等人口统计学变量。代谢综合征的定义为体重指数超过 30kg/m²、糖尿病、高血压和高胆固醇血症。采用 logistic 回归分析代谢综合征与 DVT 发生率的关系。
症状性 DVT 的总发生率为 4.4%（65/1460）。与无代谢综合征的患者相比，患有代谢综合征的患者 DVT 的发生率更高（15.5% vs. 3.4%）。调整分析显示，代谢综合征患者发生症状性 DVT 的风险是无代谢综合征患者的 3.2 倍[比值比 3.2，95%置信区间（1.0，15.4），p=0.04]。
针对 TKR 后预防性抗凝制定的医院方案应特别考虑代谢综合征患者。
