Gade Inger Lise, Kold Søren, Severinsen Marianne T, Kragholm Kristian H, Torp-Pedersen Christian, Kristensen Søren R, Riddersholm Signe J
Department of Hematology and Clinical Cancer Research Center Aalborg University Hospital Aalborg Denmark.
Department of Clinical Biochemistry Aalborg University Hospital Aalborg Denmark.
Res Pract Thromb Haemost. 2020 Nov 30;5(1):148-158. doi: 10.1002/rth2.12449. eCollection 2021 Jan.
Venous thromboembolism (VTE) causes morbidity and mortality in the general population. Several events occur after lower limb orthopedic surgery, but the contribution from various types of lower limb surgery is not well known.
To investigate the postoperative incidence of VTE for all types of lower extremity orthopedic surgery compared with the background population.
Individual-level linkage of Danish nationwide register data for all Danish residents with first-time orthopedic surgery of the lower limb (1996-2017) and, for each of these, four controls from the general population matched on age, sex, and history of VTE. Adjusted hazard ratios (HR) compared the postoperative risk of VTE to the matched controls.
In total 7203 of the 1 012 823 patients with a first orthopedic procedure had a VTE within 180 days after surgery, corresponding to a postoperative cumulative incidence of 0.71% (95% confidence interval [CI], 0.70-0.73). The cumulative incidence of VTE among controls was 0.11% (95% CI, 0.11-0.12). The HR of VTE within the first 30 days after surgery below knee level was 20.5 (95% CI, 17.9-23.5) compared with matched controls. The HRs of VTE after minor distal procedures (eg, meniscectomy and arthroscopies) were 2.9 (95% CI, 1.9-4.4) to 7.1 (95% CI, 6.4-8.0).
All types of lower limb orthopedic surgery including minor distal procedures were associated with higher rates of VTE compared with matched controls, in particular within the first 30 days after surgery.
静脉血栓栓塞症（VTE）在普通人群中会导致发病和死亡。下肢骨科手术后会发生多种情况，但各类下肢手术的影响尚不明确。
调查所有类型下肢骨科手术后VTE的发生率，并与普通人群进行比较。
对丹麦全国范围内所有接受首次下肢骨科手术的居民（1996 - 2017年）的个体层面登记数据进行关联分析，并为每位患者匹配4名年龄、性别和VTE病史相同的普通人群作为对照。通过调整后的风险比（HR）比较术后VTE风险与匹配对照。
在1012823例接受首次骨科手术的患者中，共有7203例在术后180天内发生VTE，术后累积发生率为0.71%（95%置信区间[CI]，0.70 - 0.73）。对照组中VTE的累积发生率为0.11%（95%CI，0.11 - 0.12）。与匹配对照相比，膝关节以下手术术后30天内VTE的HR为20.5（95%CI，17.9 - 23.5）。小远端手术（如半月板切除术和关节镜检查）后VTE的HR为2.9（95%CI，1.9 - 4.4）至7.1（95%CI，6.4 - 8.0）。
与匹配对照相比，包括小远端手术在内的所有类型下肢骨科手术都与较高的VTE发生率相关，尤其是在术后30天内。
