Nanjing Medical University, Nanjing, China.
Department of Orthopedics, the Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, China.
BMC Musculoskelet Disord. 2022 Aug 12;23(1):767. doi: 10.1186/s12891-022-05712-z.
Deep vein thrombosis (DVT) was a fatal complication of knee arthroplasty. We had neglected the risk factors of preoperative DVT although patients undergoing knee arthroplasty were at high risk for VTE. This study was to determine the risk factors for preoperative DVT and application of Caprini Risk Assessment Model (RAM) in patients with end-stage knee osteoarthritis (OA).
We retrospectively analyzed 1808 cases with end-stage knee OA undergoing primary knee arthroplasty from May 2015 to December 2020. Based on the results of ultrasonography in lower extremities, all patients were divided into non-DVT group and DVT group. Distribution of risk factors and risk levels were compared using χ test between two groups. Binary logistic regression analysis was used to determine the risk factors and relationship of risk levels and preoperative DVT.
The incidence of preoperative DVT was 5.53% (n = 100). Distribution of the study population by risk level was low, 4.09%; moderate, 23.95%; high, 66.98%; and highest 4.98%. Female (P = 0.002), age (P = 0.012), swollen legs (P = 0.035) and history of blood clots (P < 0.001) was correlated with preoperative DVT. Difference among four risk levels was significant (P = 0.007). Patients with highest risk level had statistically significant association with preoperative DVT (P = 0.005, OR = 2.93, 95%CI [1.375-6.246]).
The incidence of preoperative DVT was 5.53% in end-stage knee OA patients. The gender (female) and age were independent risk factors for preoperative DVT. The risk group classification by Caprini RAM was significantly associated with preoperative DVT. The usage of Caprini RAM before knee arthroplasty may be beneficial for prophylaxis of DVT.
深静脉血栓形成（DVT）是膝关节置换术的致命并发症。尽管膝关节置换术患者存在静脉血栓栓塞（VTE）的高风险，但我们忽略了术前 DVT 的危险因素。本研究旨在确定终末期膝关节骨关节炎（OA）患者术前 DVT 的危险因素，并应用卡普里风险评估模型（RAM）。
我们回顾性分析了 2015 年 5 月至 2020 年 12 月期间 1808 例接受初次膝关节置换术的终末期膝关节 OA 患者。根据下肢超声结果，所有患者分为非 DVT 组和 DVT 组。比较两组患者的危险因素分布和风险水平。采用二元逻辑回归分析确定术前 DVT 的危险因素及风险水平与术前 DVT 的关系。
术前 DVT 的发生率为 5.53%（n=100）。按风险水平分布的研究人群为低危，4.09%；中危，23.95%；高危，66.98%；极高危，4.98%。女性（P=0.002）、年龄（P=0.012）、腿部肿胀（P=0.035）和血栓形成史（P<0.001）与术前 DVT 相关。四个风险水平之间的差异有统计学意义（P=0.007）。高危组与术前 DVT 有统计学显著相关性（P=0.005，OR=2.93，95%CI[1.375-6.246]）。
终末期膝关节 OA 患者术前 DVT 的发生率为 5.53%。性别（女性）和年龄是术前 DVT 的独立危险因素。卡普里 RAM 风险组分类与术前 DVT 显著相关。膝关节置换术前使用卡普里 RAM 可能有利于预防 DVT。
