Risk of venous thromboembolism after endoprosthetic surgeries: lower versus upper extremity endoprosthetic surgeries

Venous thromboembolism (VTE) is a potentially fatal disease. Important risk factors of a provoked VTE are trauma, surgery or immobilization. Especially, patients who undergo hip and knee replacements are at high risk for postoperative VTE. We aimed to compare in-hospital VTE burden and other outcome...

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Veröffentlicht in:Heart and vessels 2019-05, Vol.34 (5), p.815-823
Hauptverfasser: Keller, Karsten, Hobohm, Lukas, Engelhardt, Martin
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Engelhardt, Martin
description Venous thromboembolism (VTE) is a potentially fatal disease. Important risk factors of a provoked VTE are trauma, surgery or immobilization. Especially, patients who undergo hip and knee replacements are at high risk for postoperative VTE. We aimed to compare in-hospital VTE burden and other outcomes after upper and lower extremity endoprosthetic surgeries in Germany. The nationwide German inpatient sample of the years 2005–2015 was used for data analysis. Patients who underwent endoprosthetic joint/bone replacements of the extremities (OPS codes 5-820, 5-822, 5-824 and 5-826) were further stratified in those operated on lower (OPS codes 5-820, 5-822 and 5-826) or upper extremity (OPS code 5-824) joints. Patients operated at upper and lower extremity were compared and lower extremity endoprosthetic surgery was investigated as a predictor for adverse outcomes. Overall, 4,134,088 hospitalized patients with extremity joint endoprosthetic surgeries (64.3% females, 54.0% aged > 70 years) were included in our analysis. Of these, 3,950,668 patients (95.6%) undergo lower and 183,420 (4.4%) upper extremity endoprosthetic joint surgery. VTE [RR 2.60 (95% CI 2.41–2.79), P  
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Important risk factors of a provoked VTE are trauma, surgery or immobilization. Especially, patients who undergo hip and knee replacements are at high risk for postoperative VTE. We aimed to compare in-hospital VTE burden and other outcomes after upper and lower extremity endoprosthetic surgeries in Germany. The nationwide German inpatient sample of the years 2005–2015 was used for data analysis. Patients who underwent endoprosthetic joint/bone replacements of the extremities (OPS codes 5-820, 5-822, 5-824 and 5-826) were further stratified in those operated on lower (OPS codes 5-820, 5-822 and 5-826) or upper extremity (OPS code 5-824) joints. Patients operated at upper and lower extremity were compared and lower extremity endoprosthetic surgery was investigated as a predictor for adverse outcomes. Overall, 4,134,088 hospitalized patients with extremity joint endoprosthetic surgeries (64.3% females, 54.0% aged &gt; 70 years) were included in our analysis. Of these, 3,950,668 patients (95.6%) undergo lower and 183,420 (4.4%) upper extremity endoprosthetic joint surgery. VTE [RR 2.60 (95% CI 2.41–2.79), P  &lt; 0.001] and all-cause death [RR 1.68 (95% CI 1.58–1.77), P  &lt; 0.001] were more common in patients with lower extremity joint surgery. Risk for VTE events [OR 2.69 (2.50–2.90), P  &lt; 0.001] and in-hospital death [OR 1.65 (1.56–1.75), P  &lt; 0.001] were both higher in lower than in upper extremity joint surgeries independently of age, sex and comorbidities. Patients who undergo lower extremity endoprosthetic joint surgeries, bear a higher risk for VTE and in-hospital death compared to those with upper extremity endoprosthetic joint surgeries.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-018-1305-3</identifier><identifier>PMID: 30443766</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Comorbidity ; Data analysis ; Death ; Extremities ; Health risks ; Immobilization ; Joint surgery ; Joints (anatomy) ; Medicine ; Medicine &amp; Public Health ; Mortality ; Original Article ; Patients ; Pulmonary embolisms ; Risk analysis ; Risk factors ; Surgery ; Thromboembolism ; Trauma ; Vascular Surgery</subject><ispartof>Heart and vessels, 2019-05, Vol.34 (5), p.815-823</ispartof><rights>Springer Japan KK, part of Springer Nature 2018</rights><rights>Springer Japan KK, part of Springer Nature 2018.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-78a0f19d2cb9eb482d7149bee56658c62ae7515b20cc47b1abc8cf7ae7f862613</citedby><cites>FETCH-LOGICAL-c396t-78a0f19d2cb9eb482d7149bee56658c62ae7515b20cc47b1abc8cf7ae7f862613</cites><orcidid>0000-0002-0820-9584</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-018-1305-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-018-1305-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30443766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keller, Karsten</creatorcontrib><creatorcontrib>Hobohm, Lukas</creatorcontrib><creatorcontrib>Engelhardt, Martin</creatorcontrib><title>Risk of venous thromboembolism after endoprosthetic surgeries: lower versus upper extremity endoprosthetic surgeries</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Venous thromboembolism (VTE) is a potentially fatal disease. Important risk factors of a provoked VTE are trauma, surgery or immobilization. Especially, patients who undergo hip and knee replacements are at high risk for postoperative VTE. We aimed to compare in-hospital VTE burden and other outcomes after upper and lower extremity endoprosthetic surgeries in Germany. The nationwide German inpatient sample of the years 2005–2015 was used for data analysis. Patients who underwent endoprosthetic joint/bone replacements of the extremities (OPS codes 5-820, 5-822, 5-824 and 5-826) were further stratified in those operated on lower (OPS codes 5-820, 5-822 and 5-826) or upper extremity (OPS code 5-824) joints. Patients operated at upper and lower extremity were compared and lower extremity endoprosthetic surgery was investigated as a predictor for adverse outcomes. Overall, 4,134,088 hospitalized patients with extremity joint endoprosthetic surgeries (64.3% females, 54.0% aged &gt; 70 years) were included in our analysis. Of these, 3,950,668 patients (95.6%) undergo lower and 183,420 (4.4%) upper extremity endoprosthetic joint surgery. VTE [RR 2.60 (95% CI 2.41–2.79), P  &lt; 0.001] and all-cause death [RR 1.68 (95% CI 1.58–1.77), P  &lt; 0.001] were more common in patients with lower extremity joint surgery. Risk for VTE events [OR 2.69 (2.50–2.90), P  &lt; 0.001] and in-hospital death [OR 1.65 (1.56–1.75), P  &lt; 0.001] were both higher in lower than in upper extremity joint surgeries independently of age, sex and comorbidities. Patients who undergo lower extremity endoprosthetic joint surgeries, bear a higher risk for VTE and in-hospital death compared to those with upper extremity endoprosthetic joint surgeries.</description><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Comorbidity</subject><subject>Data analysis</subject><subject>Death</subject><subject>Extremities</subject><subject>Health risks</subject><subject>Immobilization</subject><subject>Joint surgery</subject><subject>Joints (anatomy)</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Mortality</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pulmonary embolisms</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Thromboembolism</subject><subject>Trauma</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kU1LAzEQhoMotlZ_gBdZ8OJlNZNskl1vUvyCgiB6DrvprN26HzXJVvvvTWlVEHoIgczzvjOTl5BToJdAqbpylPKUxhTSGDgVMd8jQ5AgYiYU3ydDmgGNU87UgBw5N6cURAbZIRlwmiRcSTkk_rly71FXRktsu95Ffma7pugwnLpyTZSXHm2E7bRb2M75GfrKRK63b2grdNdR3X2G-hKtC-J-sVjDX95iU_nVTtkxOSjz2uHJ9h6R17vbl_FDPHm6fxzfTGLDM-ljlea0hGzKTJFhkaRsqiDJCkQhpUiNZDkqAaJg1JhEFZAXJjWlCq9lKpkEPiIXG98wxEePzuumcgbrOm8xLKsZcAEsAa4Cev4PnXe9bcN0mslMAiieiEDBhjJhK2ex1AtbNbldaaB6HYneRKJDJHodieZBc7Z17osGp7-KnwwCwDaAC6U2_NBf692u31sRmZw</recordid><startdate>20190501</startdate><enddate>20190501</enddate><creator>Keller, Karsten</creator><creator>Hobohm, Lukas</creator><creator>Engelhardt, Martin</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0820-9584</orcidid></search><sort><creationdate>20190501</creationdate><title>Risk of venous thromboembolism after endoprosthetic surgeries: lower versus upper extremity endoprosthetic surgeries</title><author>Keller, Karsten ; Hobohm, Lukas ; Engelhardt, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-78a0f19d2cb9eb482d7149bee56658c62ae7515b20cc47b1abc8cf7ae7f862613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Comorbidity</topic><topic>Data analysis</topic><topic>Death</topic><topic>Extremities</topic><topic>Health risks</topic><topic>Immobilization</topic><topic>Joint surgery</topic><topic>Joints (anatomy)</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Mortality</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pulmonary embolisms</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Thromboembolism</topic><topic>Trauma</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keller, Karsten</creatorcontrib><creatorcontrib>Hobohm, Lukas</creatorcontrib><creatorcontrib>Engelhardt, Martin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keller, Karsten</au><au>Hobohm, Lukas</au><au>Engelhardt, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of venous thromboembolism after endoprosthetic surgeries: lower versus upper extremity endoprosthetic surgeries</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2019-05-01</date><risdate>2019</risdate><volume>34</volume><issue>5</issue><spage>815</spage><epage>823</epage><pages>815-823</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Venous thromboembolism (VTE) is a potentially fatal disease. 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Of these, 3,950,668 patients (95.6%) undergo lower and 183,420 (4.4%) upper extremity endoprosthetic joint surgery. VTE [RR 2.60 (95% CI 2.41–2.79), P  &lt; 0.001] and all-cause death [RR 1.68 (95% CI 1.58–1.77), P  &lt; 0.001] were more common in patients with lower extremity joint surgery. Risk for VTE events [OR 2.69 (2.50–2.90), P  &lt; 0.001] and in-hospital death [OR 1.65 (1.56–1.75), P  &lt; 0.001] were both higher in lower than in upper extremity joint surgeries independently of age, sex and comorbidities. Patients who undergo lower extremity endoprosthetic joint surgeries, bear a higher risk for VTE and in-hospital death compared to those with upper extremity endoprosthetic joint surgeries.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>30443766</pmid><doi>10.1007/s00380-018-1305-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0820-9584</orcidid></addata></record>
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subjects Biomedical Engineering and Bioengineering
Cardiac Surgery
Cardiology
Comorbidity
Data analysis
Death
Extremities
Health risks
Immobilization
Joint surgery
Joints (anatomy)
Medicine
Medicine & Public Health
Mortality
Original Article
Patients
Pulmonary embolisms
Risk analysis
Risk factors
Surgery
Thromboembolism
Trauma
Vascular Surgery
title Risk of venous thromboembolism after endoprosthetic surgeries: lower versus upper extremity endoprosthetic surgeries
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