Abstract
BackgroundRisk factors for venous thromboembolism (VTE) of total joint arthroplasty (TJA) have been examined by many studies. A comprehensive systematic review of recent findings of high evidence level in this topic is needed.MethodsWe conducted a PubMed search for papers published between 2003 and 2013 that provided level-I and level-II evidences on risk factors for VTE of TJA. For each potential factors examined in at least three papers, we summarize the the number of the papers and confirmed the direction of statistically significant associations, e.g. “risk factor” “protective factor” or “controversial factor”.ResultsFifty-four papers were included in the systematic review. Risk factors found to be associated with VTE of both total hip arthroplasty and total knee arthroplasty included older age, female sex, higher BMI, bilateral surgery, surgery time > 2 hours. VTE history was found as a VTE risk factor of THA but an controversial factor of TKA. Cemented fixation as compared to cementless fixation was found as a risk factor for VTE only of TKA. TKA surgery itself was confirmed as a VTE risk factor compared with THA surgery.ConclusionsThis systematic review of high level evidences published in recent ten years identified a range of potential factors associated with VTE risk of total joint arthroplasty. These results can provide informations in this topic for doctors, patients and researchers.
Highlights
Risk factors for venous thromboembolism (VTE) of total joint arthroplasty (TJA) have been examined by many studies
Patients are suffering from 10 times of healthcare costs and more than twice of length staying in hospital compared with those without VTE, and the mortality rate associated with pulmonary embolism (PE) is reported to be 19.49% [6]
We summarize all factors examined by at least one study in Tables 4, 5, 6, 7, 8 and 9, in which the factors were classified into five aspects: demographic factors, clinical factors, laboratory indexes, health care provider-related factors and
Summary
Risk factors for venous thromboembolism (VTE) of total joint arthroplasty (TJA) have been examined by many studies. Among in-hospital patients who received recommended VTE prophylaxis, symptomatic deep vein thrombosis (DVT) rates were 0.26%-0.63% and rates for pulmonary embolism (PE) were 0.14%-0.27% after total joint arthroplasty, reported by a systematic review [5]. Several individual studies [7] focusing on specific risk factors such as previous thrombosis, malignancy and so forth represent a potential wealth of evidence regarding a range of VTE risk factors after TJA. A table of “commonly cited risk factors” for VTE after total joint arthroplasty provided by AAOS [8] can be applied to clinical practice in risk identifying. There have been no efforts to aggregate existing reservoir of evidence of a more comprehensive set of risk factors, to our knowledge
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