Newman Jared M, Abola Matthew V, Macpherson Alexandra, Klika Alison K, Barsoum Wael K, Higuera Carlos A
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
J Arthroplasty. 2017 Sep;32(9S):S254-S258. doi: 10.1016/j.arth.2017.02.063. Epub 2017 Mar 2.
The study's purpose was to determine if there is an association between ABO blood group and the development of symptomatic venous thromboembolism (VTE) after total joint arthroplasty (TJA).
A total of 28,025 patients who underwent primary TJA at a single health care system from 2000 to 2014 were retrospectively reviewed from electronic records. Patients who experienced a symptomatic VTE were identified. A multivariate regression model adjusted for known potential risk factors, including age, gender, body mass index, surgery type, previous VTE, smokers, rheumatologic diseases, malignancy, hypercoagulable state, and VTE prophylaxis, was developed to test the association of ABO blood group and postoperative VTE. Separate multivariate regressions were performed for total knee arthroplasty and total hip arthroplasty, specifically looking at pulmonary embolism.
The risk of symptomatic VTE after TJA was increased in AB blood group patients (odds ratio = 1.4; P = .03). Furthermore, the risk of pulmonary embolism was increased after total knee arthroplasty in AB blood group patients (odds ratio = 2.24; P = .001) but not after total hip arthroplasty (P = .742).
AB blood group increased the risk of VTE after TJA. Patient's ABO blood group should be considered in terms of risk stratification and selection of appropriate postoperative VTE prophylaxis.
本研究的目的是确定ABO血型与全关节置换术（TJA）后症状性静脉血栓栓塞症（VTE）的发生之间是否存在关联。
对2000年至2014年在单一医疗保健系统接受初次TJA的28025例患者的电子记录进行回顾性分析。确定发生症状性VTE的患者。建立一个多变量回归模型，对已知的潜在风险因素进行校正，包括年龄、性别、体重指数、手术类型、既往VTE史、吸烟者、风湿性疾病、恶性肿瘤、高凝状态和VTE预防措施，以检验ABO血型与术后VTE的关联。对全膝关节置换术和全髋关节置换术分别进行多变量回归分析，特别关注肺栓塞。
AB血型患者TJA后发生症状性VTE的风险增加（比值比=1.4；P=0.03）。此外，AB血型患者全膝关节置换术后肺栓塞风险增加（比值比=2.24；P=0.001），但全髋关节置换术后未增加（P=0.742）。
AB血型增加了TJA后VTE的风险。在进行风险分层和选择合适的术后VTE预防措施时，应考虑患者的ABO血型。
