Momenzadeh Kaveh, Yeritsyan Diana, Mortensen Sharri, Kheir Nadim, Khak Mohammad, Caro Daniela, Kahe Farima, Abbasian Mohammadreza, Mo Chen, McNichol Megan, Paschos Nikolaos, Nazarian Ara
Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
Cardiovascular Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Dec 6;6(1):100815. doi: 10.1016/j.asmr.2023.100815. eCollection 2024 Feb.
This study aims to determine the overall incidence of venous thromboembolism (VTE) following shoulder arthroscopy and to define potential risk factors associated with its development that may help define guidelines for the use of thromboprophylaxis
A systematic review was performed using PubMed, Embase, Web of Science, CINAHL, and Cochrane databases per PRISMA guidelines. The search terms consisted of variations of "Venous Thromboembolism" and "Shoulder Arthroscopy." Information regarding arthroscopy indication, risk factors, outcomes, and patient demographics was recorded and analyzed, and pooled odds ratios were reported for each variable.
Six hundred eighty-five articles were identified in the initial search, and 35 articles reported DVT, PE, or VTE incidence following shoulder arthroscopy. Seventeen nonoverlapping articles with a unique patient population incidence rates. Four articles were then used for subgroup meta-analysis. The incidence rate of VTE was 0.24%, ranging from 0.01% to 5.7%. BMI >30 (OR = 1.46; 95% CI = [1.22, 1.74]; = 0%) and hypertension (OR = 1.64; 95% CI = [1.03, 2.6]; = 75%) were significant risk factors ( < .05) for developing VTE following shoulder arthroscopy. Diabetes (OR = 1.2; 95% CI = [0.97, 1.48]; = 0%), insulin-dependent diabetes (OR = 5.58; 95% CI = [0.12, 260.19]; = 85%), smoking (OR = 1.04; 95% CI = [0.79, 1.37]; = 12%), male sex (OR = 0.95; 95% CI = [0.49, 1.85]; = 86%) and age over 65 (OR = 4.3; 95% CI = [0.25, 72.83]; = 85%) were not associated with higher VTE risk.
The VTE incidence following shoulder arthroscopy is low at 0.24%. Patients with BMI >30 and hypertension are at a higher risk for VTE after shoulder arthroscopy.
Level IV, systematic review and meta-analysis of Level I-IV studies.
本研究旨在确定肩关节镜检查后静脉血栓栓塞症（VTE）的总体发生率，并确定与其发生相关的潜在风险因素，这可能有助于制定血栓预防措施的使用指南。
根据PRISMA指南，使用PubMed、Embase、Web of Science、CINAHL和Cochrane数据库进行系统评价。检索词包括“静脉血栓栓塞症”和“肩关节镜检查”的变体。记录并分析有关关节镜检查指征、风险因素、结果和患者人口统计学信息，并报告每个变量的合并比值比。
在初始检索中识别出685篇文章，35篇文章报告了肩关节镜检查后的深静脉血栓形成（DVT）、肺栓塞（PE）或VTE发生率。17篇文章有独特的患者群体发病率且不重叠。然后使用4篇文章进行亚组荟萃分析。VTE的发生率为0.24%，范围为0.01%至5.7%。BMI>30（比值比[OR]=1.46；95%置信区间[CI]=[1.22,1.74]；P=0%）和高血压（OR=1.64；95%CI=[1.03,2.6]；P=75%）是肩关节镜检查后发生VTE的显著风险因素（P<.05）。糖尿病（OR=1.2；95%CI=[0.97,1.48]；P=0%）、胰岛素依赖型糖尿病（OR=5.58；95%CI=[0.12,260.19]；P=85%）、吸烟（OR=1.04；95%CI=[0.79,1.37]；P=12%）、男性（OR=0.95；95%CI=[0.49,1.85]；P=86%）和65岁以上（OR=4.3；95%CI=[0.25,72.83]；P=85%）与较高的VTE风险无关。
肩关节镜检查后VTE的发生率较低，为0.24%。BMI>30和高血压的患者在肩关节镜检查后发生VTE的风险较高。
IV级，I-IV级研究的系统评价和荟萃分析。
