Abstract

This study was performed to investigate the relationship between patients’ activity and function levels and the incidence of preoperative deep venous thrombosis (DVT) prior to total hip arthroplasty (THA). We retrospectively reviewed 500 patients admitted for primary or revision THA from July 2014 to October 2018. The diagnosis of DVT was confirmed using Doppler ultrasonography 1 month before THA. The patients’ activity and hip function were evaluated using several clinical scores: the Harris Hip Score (HHS), Oxford Hip Score (OHS), University of California Los Angeles (UCLA) activity score, and visual analog scale (VAS) score. Those scores and the medical history were examined for correlations with preoperative DVT using univariate and multivariate models. Univariate regression analysis showed that older age, current steroid use, anticoagulant use, a history of DVT, collagen disease, a lower UCLA activity score, and a lower OHS were associated with an elevated risk of preoperative DVT. The multivariate analyses showed that a higher UCLA activity score (odds ratio (OR): 0.0049–0.012) and higher OHS (OR: 0.0012–0.0088) were associated with a lower risk of preoperative DVT in each model. Age (OR: 1.07 in both models), current steroid use (OR: 9.32–10.45), and a history of DVT (OR: 27.15–74.98) were associated with a higher risk of preoperative DVT in both models. Older age, current steroid use, a history of DVT, a lower UCLA activity score, and a lower OHS were risk factors for preoperative DVT before THA, even when controlling for potential confounders. Patients exhibiting low activity and low function levels were more likely to have DVT, even before surgery.

Highlights

  • Deep venous thromboembolism (DVT) is still a common complication after hip arthroplasty and can lead to pulmonary thromboembolism (PTE), recent reviews have shown a significant decrease in the incidence of fatal PTE after total hip arthroplasty (THA) [1,2]

  • Older age is a predictor of preoperative DVT after THA [6,7,8,9,10,11,12,13] and before THA [5]

  • Our results demonstrated that older patients were significantly more likely to have DVT before THA

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Summary

Introduction

Deep venous thromboembolism (DVT) is still a common complication after hip arthroplasty and can lead to pulmonary thromboembolism (PTE), recent reviews have shown a significant decrease in the incidence of fatal PTE after total hip arthroplasty (THA) [1,2]. According to the American College of Chest Physicians’ evidence-based clinical practice guideline, hip surgery itself is a risk factor for DVT [3]. If patients undergoing THA have DVT before the surgery, the risk of extension of the thrombus and fatal PTE could be higher. To avoid critical complications associated with significant mortality, it is essential to determine the risk factors for DVT in patients with hip disability undergoing THA A few studies have investigated the incidence of and risk factors for preoperative DVT [4,5], and these studies showed that the prevalence of DVT prior to THA ranged from 5% to 12%.

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