Parameswaran Apurve, Krishnamoorthy Vignesh P, Oommen Anil T, Jasper Anita, Korula Ravi J, Nair Sukesh C, Poonnoose Pradeep M
Department of Orthopaedics-Unit II, Christian Medical College, Vellore 632004, Tamil Nadu, India.
Department of Radiology, Christian Medical College, Vellore 632004, Tamil Nadu, India.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):225-229. doi: 10.1016/j.jcot.2016.08.003. Epub 2016 Aug 24.
Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication.
The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented. Diagnosis of DVT was made with Duplex ultrasonography. We also assessed the usefulness of pre-operative assessment of the hypercoagulable status of the patient in predicting the occurrence of VTE, using the Thrombelastography (TEG) test.
The incidence of DVT in the study population was 7%. Six of the 7 patients who developed DVT had surgery for hip fractures, while one had knee replacement. The thrombus was above the knee joint level in 6 of the 7 patients. Pre-operative TEG was positive in only one of the 7 patients, but was positive in 37 of the remaining 94 patients.
Incidence of DVT in the study population is sufficiently high to recommend some form of prophylaxis to prevent VTE following hip and knee surgery. Pre-operative assessment of the patients' coagulation status with Thrombelastography does not predict the risk of VTE. The use of other lab parameters that could help in selective chemoprophylaxis needs to be explored.
关于印度人群静脉血栓栓塞症（VTE）发病率的流行病学数据差异很大。大多数研究表明，亚洲患者VTE的发病率低于西方人群。识别高危患者的筛查工具应能帮助我们减少这种并发症。
记录了101例接受膝关节或髋关节置换术或髋部骨折手术且未进行深静脉血栓形成（DVT）化学预防的患者的VTE发病率。通过双功超声检查诊断DVT。我们还使用血栓弹力图（TEG）试验评估术前评估患者高凝状态对预测VTE发生的有用性。
研究人群中DVT的发病率为7%。发生DVT的7例患者中，6例接受了髋部骨折手术，1例接受了膝关节置换术。7例患者中有6例血栓位于膝关节以上水平。术前TEG在7例患者中仅1例呈阳性，但在其余94例患者中有37例呈阳性。
研究人群中DVT的发病率足够高，足以推荐某种形式的预防措施以防止髋部和膝关节手术后发生VTE。用血栓弹力图对患者凝血状态进行术前评估不能预测VTE风险。需要探索使用其他有助于选择性化学预防的实验室参数。
