Risk factors for venous thromboembolism after total hip and total knee arthroplasty: a meta-analysis
Introduction Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) or total knee arthroplasty (TKA) and may be the cause for a secondary PE and associated morbidity/mortality. We performed a systematic literature review of risk factors and risk reduction of VTE aft...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2015-06, Vol.135 (6), p.759-772 |
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| creator | Zhang, Jie Chen, Zhihao Zheng, Jilin Breusch, Steffen J Tian, Jing |
| description | Introduction
Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) or total knee arthroplasty (TKA) and may be the cause for a secondary PE and associated morbidity/mortality. We performed a systematic literature review of risk factors and risk reduction of VTE after THA or TKA.
Materials and methods
A systematic search of PubMed database, the Cochrane Library, OVID MEDLINE and American Academy of Orthopaedic Surgeons (AAOS), without restriction of publication data and language, was conducted. We performed a meta-analysis of ten factors for VTE after THA or TKA. Four authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale (NOS) as quality assessment tool. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.2.9.
Results
Fourteen retrospective case–control or prospective cohort studies, which included 18,075 patients who developed VTE after THA or TKA of a total of 1,723,350 cases, were selected. Our results demonstrated that, among all ten factors investigated, 3 main risk factors were significantly associated with VTE after THA or TKA: history of VTE (RR > 10.6), varicose vein (RR > 2.7) and congestive cardiac failure (RR 2). There was also an increase of VTE risk ranging from 8 to 30 % for female gender |
| doi_str_mv | 10.1007/s00402-015-2208-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1682203573</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1682203573</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-46e99bd3696a1b015469799a4c05f3e2078dccae7a8fc09b32429b8eef81eadb3</originalsourceid><addsrcrecordid>eNp1kUuLFDEUhYMoTjv6A9xIwI2b6M2jUok7GXzBgDDMrMOtqltOzVRV2iQ90P9-0nSrILgIIeQ75z4OY68lvJcA7YcMYEAJkI1QCpxwT9hGGm2E9tI-ZRvw2goHjTxjL3K-A5DKeXjOzlTjGmMbs2HD1ZTv-Yh9iSnzMSb-QGvcZV5uU1y6SPXMU144joUSL7HgzG-nLcd1OL3uVyKO6SDYzpjL_iNHvlBBgSvO-zzll-zZiHOmV6f7nN18-Xx98U1c_vj6_eLTpegbcEUYS953g7beouzqVMb61ns0PTSjJgWtG_oeqUU39uA7rYzynSManSQcOn3O3h19tyn-2lEuYZlyT_OMK9WZgrSu7kk3ra7o23_Qu7hLtd8clLLSt651UCl5pPoUc040hm2aFkz7ICEcIgjHCEJtNhwiCK5q3pycd91Cwx_F751XQB2BXL_Wn5T-lv6_6yO6MpHh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261978780</pqid></control><display><type>article</type><title>Risk factors for venous thromboembolism after total hip and total knee arthroplasty: a meta-analysis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Zhang, Jie ; Chen, Zhihao ; Zheng, Jilin ; Breusch, Steffen J ; Tian, Jing</creator><creatorcontrib>Zhang, Jie ; Chen, Zhihao ; Zheng, Jilin ; Breusch, Steffen J ; Tian, Jing</creatorcontrib><description>Introduction
Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) or total knee arthroplasty (TKA) and may be the cause for a secondary PE and associated morbidity/mortality. We performed a systematic literature review of risk factors and risk reduction of VTE after THA or TKA.
Materials and methods
A systematic search of PubMed database, the Cochrane Library, OVID MEDLINE and American Academy of Orthopaedic Surgeons (AAOS), without restriction of publication data and language, was conducted. We performed a meta-analysis of ten factors for VTE after THA or TKA. Four authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale (NOS) as quality assessment tool. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.2.9.
Results
Fourteen retrospective case–control or prospective cohort studies, which included 18,075 patients who developed VTE after THA or TKA of a total of 1,723,350 cases, were selected. Our results demonstrated that, among all ten factors investigated, 3 main risk factors were significantly associated with VTE after THA or TKA: history of VTE (RR > 10.6), varicose vein (RR > 2.7) and congestive cardiac failure (RR 2). There was also an increase of VTE risk ranging from 8 to 30 % for female gender < age (≥80) < hypertension < (active) cancer < obesity (BMI ≥ 30) < (black) race. Data analysis revealed that diabetes mellitus had no significant relationship with VTE after THA or TKA.
Conclusions
This study highlighted the role of nine significant risk factors in the development of VTE after THA or TKA. Among all risk factors, history of VTE seems the one main indication for more potent anticoagulation. All other risk factors need to be considered and discussed with patients individually and balanced against the risk of bleeding and infection. Individual patient risk assessment, rather than a “blanket policy”, is considered the best management strategy before deciding on the type of chemical prophylaxis.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-015-2208-8</identifier><identifier>PMID: 25854654</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; Global Health ; Humans ; Incidence ; Joint surgery ; Medicine ; Medicine & Public Health ; Meta-analysis ; Orthopaedic Surgery ; Orthopedics ; Postoperative Complications ; Risk Assessment ; Risk Factors ; Survival Rate - trends ; Thromboembolism ; Venous Thromboembolism - epidemiology ; Venous Thromboembolism - etiology</subject><ispartof>Archives of orthopaedic and trauma surgery, 2015-06, Vol.135 (6), p.759-772</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2015). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-46e99bd3696a1b015469799a4c05f3e2078dccae7a8fc09b32429b8eef81eadb3</citedby><cites>FETCH-LOGICAL-c508t-46e99bd3696a1b015469799a4c05f3e2078dccae7a8fc09b32429b8eef81eadb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-015-2208-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-015-2208-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27928,27929,41492,42561,51323</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25854654$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Jie</creatorcontrib><creatorcontrib>Chen, Zhihao</creatorcontrib><creatorcontrib>Zheng, Jilin</creatorcontrib><creatorcontrib>Breusch, Steffen J</creatorcontrib><creatorcontrib>Tian, Jing</creatorcontrib><title>Risk factors for venous thromboembolism after total hip and total knee arthroplasty: a meta-analysis</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) or total knee arthroplasty (TKA) and may be the cause for a secondary PE and associated morbidity/mortality. We performed a systematic literature review of risk factors and risk reduction of VTE after THA or TKA.
Materials and methods
A systematic search of PubMed database, the Cochrane Library, OVID MEDLINE and American Academy of Orthopaedic Surgeons (AAOS), without restriction of publication data and language, was conducted. We performed a meta-analysis of ten factors for VTE after THA or TKA. Four authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale (NOS) as quality assessment tool. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.2.9.
Results
Fourteen retrospective case–control or prospective cohort studies, which included 18,075 patients who developed VTE after THA or TKA of a total of 1,723,350 cases, were selected. Our results demonstrated that, among all ten factors investigated, 3 main risk factors were significantly associated with VTE after THA or TKA: history of VTE (RR > 10.6), varicose vein (RR > 2.7) and congestive cardiac failure (RR 2). There was also an increase of VTE risk ranging from 8 to 30 % for female gender < age (≥80) < hypertension < (active) cancer < obesity (BMI ≥ 30) < (black) race. Data analysis revealed that diabetes mellitus had no significant relationship with VTE after THA or TKA.
Conclusions
This study highlighted the role of nine significant risk factors in the development of VTE after THA or TKA. Among all risk factors, history of VTE seems the one main indication for more potent anticoagulation. All other risk factors need to be considered and discussed with patients individually and balanced against the risk of bleeding and infection. Individual patient risk assessment, rather than a “blanket policy”, is considered the best management strategy before deciding on the type of chemical prophylaxis.</description><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Global Health</subject><subject>Humans</subject><subject>Incidence</subject><subject>Joint surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Postoperative Complications</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Survival Rate - trends</subject><subject>Thromboembolism</subject><subject>Venous Thromboembolism - epidemiology</subject><subject>Venous Thromboembolism - etiology</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUuLFDEUhYMoTjv6A9xIwI2b6M2jUok7GXzBgDDMrMOtqltOzVRV2iQ90P9-0nSrILgIIeQ75z4OY68lvJcA7YcMYEAJkI1QCpxwT9hGGm2E9tI-ZRvw2goHjTxjL3K-A5DKeXjOzlTjGmMbs2HD1ZTv-Yh9iSnzMSb-QGvcZV5uU1y6SPXMU144joUSL7HgzG-nLcd1OL3uVyKO6SDYzpjL_iNHvlBBgSvO-zzll-zZiHOmV6f7nN18-Xx98U1c_vj6_eLTpegbcEUYS953g7beouzqVMb61ns0PTSjJgWtG_oeqUU39uA7rYzynSManSQcOn3O3h19tyn-2lEuYZlyT_OMK9WZgrSu7kk3ra7o23_Qu7hLtd8clLLSt651UCl5pPoUc040hm2aFkz7ICEcIgjHCEJtNhwiCK5q3pycd91Cwx_F751XQB2BXL_Wn5T-lv6_6yO6MpHh</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Zhang, Jie</creator><creator>Chen, Zhihao</creator><creator>Zheng, Jilin</creator><creator>Breusch, Steffen J</creator><creator>Tian, Jing</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>Risk factors for venous thromboembolism after total hip and total knee arthroplasty: a meta-analysis</title><author>Zhang, Jie ; Chen, Zhihao ; Zheng, Jilin ; Breusch, Steffen J ; Tian, Jing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-46e99bd3696a1b015469799a4c05f3e2078dccae7a8fc09b32429b8eef81eadb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Global Health</topic><topic>Humans</topic><topic>Incidence</topic><topic>Joint surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Postoperative Complications</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>Thromboembolism</topic><topic>Venous Thromboembolism - epidemiology</topic><topic>Venous Thromboembolism - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Jie</creatorcontrib><creatorcontrib>Chen, Zhihao</creatorcontrib><creatorcontrib>Zheng, Jilin</creatorcontrib><creatorcontrib>Breusch, Steffen J</creatorcontrib><creatorcontrib>Tian, Jing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Jie</au><au>Chen, Zhihao</au><au>Zheng, Jilin</au><au>Breusch, Steffen J</au><au>Tian, Jing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for venous thromboembolism after total hip and total knee arthroplasty: a meta-analysis</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>135</volume><issue>6</issue><spage>759</spage><epage>772</epage><pages>759-772</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) or total knee arthroplasty (TKA) and may be the cause for a secondary PE and associated morbidity/mortality. We performed a systematic literature review of risk factors and risk reduction of VTE after THA or TKA.
Materials and methods
A systematic search of PubMed database, the Cochrane Library, OVID MEDLINE and American Academy of Orthopaedic Surgeons (AAOS), without restriction of publication data and language, was conducted. We performed a meta-analysis of ten factors for VTE after THA or TKA. Four authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale (NOS) as quality assessment tool. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.2.9.
Results
Fourteen retrospective case–control or prospective cohort studies, which included 18,075 patients who developed VTE after THA or TKA of a total of 1,723,350 cases, were selected. Our results demonstrated that, among all ten factors investigated, 3 main risk factors were significantly associated with VTE after THA or TKA: history of VTE (RR > 10.6), varicose vein (RR > 2.7) and congestive cardiac failure (RR 2). There was also an increase of VTE risk ranging from 8 to 30 % for female gender < age (≥80) < hypertension < (active) cancer < obesity (BMI ≥ 30) < (black) race. Data analysis revealed that diabetes mellitus had no significant relationship with VTE after THA or TKA.
Conclusions
This study highlighted the role of nine significant risk factors in the development of VTE after THA or TKA. Among all risk factors, history of VTE seems the one main indication for more potent anticoagulation. All other risk factors need to be considered and discussed with patients individually and balanced against the risk of bleeding and infection. Individual patient risk assessment, rather than a “blanket policy”, is considered the best management strategy before deciding on the type of chemical prophylaxis.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25854654</pmid><doi>10.1007/s00402-015-2208-8</doi><tpages>14</tpages></addata></record> |
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| subjects | Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Knee - adverse effects Global Health Humans Incidence Joint surgery Medicine Medicine & Public Health Meta-analysis Orthopaedic Surgery Orthopedics Postoperative Complications Risk Assessment Risk Factors Survival Rate - trends Thromboembolism Venous Thromboembolism - epidemiology Venous Thromboembolism - etiology |
| title | Risk factors for venous thromboembolism after total hip and total knee arthroplasty: a meta-analysis |
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