Tay Kenny, Bin Abd Razak Hamid Rahmatullah, Tan Andrew Hwee Chye
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
J Arthroplasty. 2016 Dec;31(12):2880-2883. doi: 10.1016/j.arth.2016.05.061. Epub 2016 Jun 4.
Venous thromboembolism (VTE) is a known complication of total knee arthroplasty (TKA). In addition, obesity has been implicated as a risk factor and justification for chemoprophylaxis for VTE. We wanted to review the prevalence of VTE among our patients and evaluate the incidence rates of VTE among nonobese and obese patients.
We reviewed 894 patients who underwent elective unilateral total knee arthroplasty by a single surgeon from March 2003 to November 2014 in our center. Any patients with clinically significant symptoms or signs of VTE such as deep venous thrombosis (DVT) or pulmonary embolism (PE) were diagnosed radiologically. The patient demographics analyzed included age, gender, body mass index, the number of comorbid diseases, and a history of hyperlipidemia.
We found the incidence of VTE of 0.67% in our patients (6 patients of 894). Four of the 6 patients (66.7%) who developed DVT and PE belonged to nonobese group. The frequency of VTE in nonobese patients was 0.65% and 0.73% in the obese patients. There were no significant differences in age, number of comorbidities, and a history of hyperlipidemia between those who developed DVT and PE and those who did not.
With the low prevalence of VTE among our study population, including patients with obesity, advanced age, multiple comorbidities, or hyperlipidemia, the practice of routine chemoprophylaxis should be reviewed.
静脉血栓栓塞症(VTE)是全膝关节置换术(TKA)已知的并发症。此外,肥胖被认为是VTE化学预防的危险因素和依据。我们想要回顾我们患者中VTE的患病率,并评估非肥胖和肥胖患者中VTE的发病率。
我们回顾了2003年3月至2014年11月在我们中心由一名外科医生进行择期单侧全膝关节置换术的894例患者。任何有临床显著VTE症状或体征(如深静脉血栓形成(DVT)或肺栓塞(PE))的患者均通过影像学诊断。分析的患者人口统计学特征包括年龄、性别、体重指数、合并疾病数量和高脂血症病史。
我们发现我们患者中VTE的发病率为0.67%(894例患者中有6例)。发生DVT和PE的6例患者中有4例(66.7%)属于非肥胖组。非肥胖患者中VTE的发生率为0.65%,肥胖患者中为0.73%。发生DVT和PE的患者与未发生的患者在年龄、合并疾病数量和高脂血症病史方面没有显著差异。
鉴于我们研究人群(包括肥胖、高龄、多种合并疾病或高脂血症患者)中VTE的患病率较低,应重新审视常规化学预防的做法。