Lu Yue, Zhou Zhen-Yu, Liu Ya-Ke, Chen Hong-Lin, Yang Hui-Lin, Liu Fan
First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
J Thromb Thrombolysis. 2016 May;41(4):556-62. doi: 10.1007/s11239-015-1283-6.
We performed a meta-analysis to evaluate gender differences of venous thromboembolism (VTE) risk after total hip (THA) and total knee arthroplasty (TKA). We searched PubMed and Web of Knowledge from their beginning to 25 July 2015. Pooled odds ratio (OR) and 95 % confidence interval (CI) for VTE risk were calculated. Twenty studies with 7,892,585 patients were included in our study. The VTE incidence ranged from 0.27 to 61.0 %. The sex ratio (male/female) was 0.623 (3,016,648/4,839,785) in no VTE group versus 0.492 (11,926/24,226) in VTE group. The pooled OR was 1.184 (95 % CI 1.070-1.310; Z = 3.28, P = 0.001). The Begg's test (z = 1.46, P = 0.144) and the Egger's test (t = 0.58, P = 0.571), and the funnel plot suggested there was no significant publication bias. Sensitivity analysis by omitted a study with largest simple size showed the pooled OR was 1.166 (95 % CI 1.051-1.294; Z = 2.91, P = 0.004) by random-effects model. Meta-regression showed VTE risk was not related with THA and TKA incidence (t = 0.35, P = 0.732). Our meta-analysis showed female patients have slightly higher risk of VTE than male patients after THA and TKA.
我们进行了一项荟萃分析，以评估全髋关节置换术（THA）和全膝关节置换术（TKA）后静脉血栓栓塞（VTE）风险的性别差异。我们检索了PubMed和Web of Knowledge从创刊至2015年7月25日的文献。计算了VTE风险的合并比值比（OR）和95%置信区间（CI）。我们的研究纳入了20项研究，共7,892,585例患者。VTE发生率在0.27%至61.0%之间。无VTE组的性别比（男性/女性）为0.623（3,016,648/4,839,785），而VTE组为0.492（11,926/24,226）。合并OR为1.184（95%CI 1.070 - 1.310；Z = 3.28，P = 0.001）。Begg检验（z = 1.46，P = 0.144）和Egger检验（t = 0.58，P = 0.571）以及漏斗图表明不存在显著的发表偏倚。通过剔除样本量最大的一项研究进行敏感性分析，随机效应模型显示合并OR为1.166（95%CI 1.051 - 1.294；Z = 2.91，P = 0.004）。Meta回归显示VTE风险与THA和TKA发生率无关（t = 0.35，P = 0.732）。我们的荟萃分析表明，THA和TKA术后女性患者发生VTE的风险略高于男性患者。
