Abstract
Background Deep vein thrombosis (DVT) is one of the major complications of total joint arthroplasty (TJA). Chronic kidney dysfunction (CKD) has proven to promote a proinflammatory and prothrombotic state and is prevalent among patients undergoing TJA. The purpose of this study is to identify whether CKD increase the risk of DVT following TJA. Methods In a retrospective study, 1274 patients who underwent primary TJA were studied. CKD is graded in 5 stages. Univariate and multivariate analysis were used to identify the association of CKD and its severity with postoperative DVT. Results There were 1139 (89.4%) participants with normal kidney function, 103 (8.1%) with mildly decreased kidney function, and 32 (2.5%) with stage 3 and 4 CKD. A total of 244 patients (19.2%) were diagnosed with DVT. Sixty-four patients (5.0%) developed symptomatic DVT. Advanced age, female gender, malignancy, and eGFR showed significant association with total DVT. BMI, thrombosis history, malignancy, and eGFR were associated with symptomatic DVT. After adjusting for age, gender, BMI, and malignancy, eGFR was found to be related to both total and symptomatic DVT. Conclusions CKD is an important risk factor for both total and symptomatic DVT following TJA. Postoperative prophylaxis should be made a priority in this population.
Highlights
Total joint arthroplasty (TJA) is an effective surgical procedure which can improve the quality of life and function of patients affected by end-stage arthritis of the hip or knee [1, 2]
In the current study, we aimed to address these questions on the basis of a large cohort of patients undergoing total joint arthroplasty (TJA) to investigate the relationship between Chronic kidney dysfunction (CKD) and the incidence of postoperative Deep vein thrombosis (DVT) and to further determine its influence on the severity of this complication
We hypothesized that CKD patients have a higher risk of developing both symptomatic and asymptomatic DVT following TJA compared with patients without CKD
Summary
Total joint arthroplasty (TJA) is an effective surgical procedure which can improve the quality of life and function of patients affected by end-stage arthritis of the hip or knee [1, 2]. VTE is a major complication including deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE cannot be effectively predicted on a combination of these risk factors. Deep vein thrombosis (DVT) is one of the major complications of total joint arthroplasty (TJA). The purpose of this study is to identify whether CKD increase the risk of DVT following TJA. Univariate and multivariate analysis were used to identify the association of CKD and its severity with postoperative DVT. Female gender, malignancy, and eGFR showed significant association with total DVT. BMI, thrombosis history, malignancy, and eGFR were associated with symptomatic DVT. After adjusting for age, gender, BMI, and malignancy, eGFR was found to be related to both total and symptomatic DVT. CKD is an important risk factor for both total and symptomatic DVT following TJA. Postoperative prophylaxis should be made a priority in this population
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