Matthews Jemma H, Terrill Alexander J, Barwick Alex L, Butterworth Paul A
School of Health and Human Sciences, Southern Cross University, Bilinga, Queensland, Australia (JHM, AJT, ALB, PAB).
Australasian College of Podiatric Surgeons, Melbourne, Victoria, Australia (PAB).
Foot Ankle Spec. 2018 Oct;11(5):444-450. doi: 10.1177/1938640017750256. Epub 2018 Jan 17.
The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thromboprophylaxis.
Data from 4238 patients who underwent foot and ankle surgery over 2 years were analyzed. Venous thromboembolism within the first 30 days following surgery was recorded using the Australasian College of Podiatric Surgeons surgical audit tool. Logistic regression analyses were undertaken to determine the factors that influenced thromboprophylaxis.
Of the 4238 patient records, 3677 records (87%) provided complete data (age range 2-94 years; mean ± SD, 49.1 ± 19.7 years; 2693 females). A total of 7 venous thromboembolic events (0.2% rate) were reported. Operative duration and age (OR 12.63, 95% CI 9.47 to 16.84, P < 0.01), postoperative immobilization (OR 6.94, 95% CI 3.95 to 12.20, P < 0.01), and a prior history of VTE (OR 3.41, 95% CI 1.01 to 11.04, P = 0.04) were the strongest predictors of thromboprophylaxis.
Podiatric foot and ankle surgery is associated with a low rate of venous thromboembolism. This may be due in part to the thromboprophylaxis regime implemented by podiatric surgeons, which closely aligns with current evidence-based guidelines.
Level II: Prospective cohort study.
足病外科医生遵循静脉血栓栓塞指南的程度尚不清楚。因此，本研究的目的有两个：（a）确定足病外科手术后静脉血栓栓塞的发生率；（b）调查影响血栓预防措施使用的因素。
分析了4238例在两年内接受足踝手术患者的数据。使用澳大利亚足病外科医生学院手术审计工具记录术后30天内的静脉血栓栓塞情况。进行逻辑回归分析以确定影响血栓预防的因素。
在4238份患者记录中，3677份记录（87%）提供了完整数据（年龄范围2 - 94岁；平均±标准差，49.1±19.7岁；女性2693例）。共报告了7例静脉血栓栓塞事件（发生率0.2%）。手术持续时间和年龄（比值比12.63，95%置信区间9.47至16.84，P < 0.01）、术后固定（比值比6.94，95%置信区间3.95至12.20，P < 0.01）以及既往静脉血栓栓塞病史（比值比3.41，95%置信区间1.01至11.04，P = 0.04）是血栓预防的最强预测因素。
足病足踝手术的静脉血栓栓塞发生率较低。这可能部分归因于足病外科医生实施的血栓预防方案，该方案与当前基于证据的指南密切一致。
二级：前瞻性队列研究。
