Division of Sports Medicine, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.
Division of Sports Medicine, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A..
Arthroscopy. 2019 Aug;35(8):2380-2384.e1. doi: 10.1016/j.arthro.2019.03.054.
To determine the incidence of symptomatic venous thromboembolism (VTE) after hip arthroscopy (HA) using a large national database while considering several patient demographic factors.
Patients ≥20 years old who underwent HA between 2007 and 2017 were identified within the Humana administrative claims database using relevant Current Procedural Terminology and International Classification of Diseases Ninth and Tenth Revision codes. Basic demographics, including age, gender, obesity (body mass index ≥ 30 kg/m), oral contraceptive use, smoking history, diabetes, and chronic obstructive pulmonary disease (CLD) were recorded. Postoperative incidence of deep vein thrombosis, pulmonary embolism, and VTE was identified at 30 and 90 days postoperatively. Multivariate logistic regression analysis was performed to identify independent risk factors for VTE after HA, with statistical significance set at P < .05.
Overall, 9,477 patients underwent HA procedures over the study period, of whom 5,085 (53.7%) were female. The overall incidence of VTE in all patients was 0.77% (n = 73) and 1.14% (n = 108) at 30 and 90 days, respectively. Multivariate analysis identified age ≥ 45 (odds ratio [OR] = 1.82; 95% confidence interval [CI], 1.36-2.49; P = .0001), obesity (OR = 1.54; 95% CI, 1.27-1.86; P < .0001), smoking (OR = 1.26; 95% CI, 1.04-1.53; P = .0177), diabetes (OR = 1.59; 95% CI, 1.32-1.92; P < .0001), and CLD (OR = 2.10; 95% CI, 1.63-2.68; P < .0001) as independent risk factors for higher incidence of VTE after HA. However, neither gender nor oral contraceptive use were risk factors for VTE after HA.
For patients undergoing HA, the incidence of symptomatic postoperative VTE is low. This study identified age ≥45, obesity, tobacco use, diabetes, and CLD as independent risk factors for VTE after HA.
Level III, retrospective cohort study.
利用大型国家数据库，考虑到几个患者人口统计学因素，确定髋关节镜检查（HA）后有症状的静脉血栓栓塞症（VTE）的发生率。
在 Humana 管理索赔数据库中，使用相关的当前程序术语和国际疾病分类第九和第十修订版代码，确定 2007 年至 2017 年间接受 HA 的年龄≥20 岁的患者。记录基本人口统计学数据，包括年龄、性别、肥胖（体重指数≥30kg/m）、口服避孕药使用、吸烟史、糖尿病和慢性阻塞性肺疾病（COPD）。术后 30 天和 90 天分别确定深静脉血栓形成、肺栓塞和 VTE 的术后发生率。使用多变量逻辑回归分析确定 HA 后 VTE 的独立危险因素，统计显著性设置为 P <.05。
总体而言，在研究期间共有 9477 例患者接受了 HA 手术，其中 5085 例（53.7%）为女性。所有患者 VTE 的总体发生率分别为 0.77%（n=73）和 1.14%（n=108），分别为术后 30 天和 90 天。多变量分析确定年龄≥45 岁（比值比[OR] = 1.82；95%置信区间[CI]，1.36-2.49；P=.0001）、肥胖（OR=1.54；95%CI，1.27-1.86；P <.0001）、吸烟（OR=1.26；95%CI，1.04-1.53；P=.0177）、糖尿病（OR=1.59；95%CI，1.32-1.92；P <.0001）和 COPD（OR=2.10；95%CI，1.63-2.68；P <.0001）是 HA 后 VTE 发生率较高的独立危险因素。然而，性别和口服避孕药的使用均不是 HA 后 VTE 的危险因素。
对于接受 HA 的患者，术后有症状 VTE 的发生率较低。本研究确定年龄≥45 岁、肥胖、吸烟、糖尿病和 COPD 是 HA 后 VTE 的独立危险因素。
III 级，回顾性队列研究。
