Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois.
J Surg Orthop Adv. 2024 Fall;33(3):138-142.
Pulmonary embolism (PE) and deep vein thrombosis (DVT) are common postoperative complications. This study retrospectively analyzes preoperative attributes as risk factors for DVT or PE following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Preoperative transfusion, age 65+, dyspnea with moderate exertion, body mass index (BMI) 24.9+ were independent risk factors for PE following THA. Cardiac comorbidities were related with reduced risk. Bleeding disorder, operative time > 110 minutes, perioperative transfusion, age 65+, dyspnea at rest, and BMI < 18.5 were independent risk factors for DVT following THA. Perioperative transfusion, age 57+, dyspnea at rest and with moderate exertion, and BMI 24.9+ were independent risk factors for PE following TKA. Smoking status was related to reduced risk. Perioperative transfusion, age 65+, dyspnea with moderate exertion, and male sex were independent risk factors for DVT following TKA. Cardiac comorbidities were related with reduced risk. Identifying risk factors helps prevent DVT and PE after THA or TKA. (Journal of Surgical Orthopaedic Advances 33(3):138-142, 2024).
肺栓塞（PE）和深静脉血栓形成（DVT）是常见的术后并发症。本研究回顾性分析了初次全髋关节置换术（THA）和全膝关节置换术（TKA）后 DVT 或 PE 的术前特征作为危险因素。THA 后发生 PE 的独立危险因素包括术前输血、年龄≥65 岁、中等体力活动时呼吸困难、体重指数（BMI）24.9+。心脏合并症与风险降低相关。出血性疾病、手术时间>110 分钟、围手术期输血、年龄≥65 岁、静息时呼吸困难和 BMI<18.5 是 THA 后发生 DVT 的独立危险因素。围手术期输血、年龄≥57 岁、静息和中等体力活动时呼吸困难以及 BMI 24.9+是 TKA 后发生 PE 的独立危险因素。吸烟状态与风险降低相关。围手术期输血、年龄≥65 岁、中等体力活动时呼吸困难以及男性是 TKA 后发生 DVT 的独立危险因素。心脏合并症与风险降低相关。确定危险因素有助于预防 THA 或 TKA 后 DVT 和 PE 的发生。（《外科矫形进展杂志》33(3):138-142, 2024）。
