Late occurring clinical deep vein thrombosis in joint-operated patients.
In a prospective study of 4,840 patients, we determined the annual incidence of clinical deep vein thrombosis (DVT) in mobilized, discharged orthopedic-operated "high-risk" patients (hip replacement surgery, knee replacement surgery, nailed hip fracture) and assumed "low-risk" patients (diagnostic knee arthroscopy). In addition, the time from the operation to the time when the patients were readmitted with clinically suspected DVT and the distribution of radiologically-confirmed DVT were recorded. Thromboprophylaxis was routinely given for about 10 days to the high-risk groups during the hospital stay but not to patients undergoing knee arthroscopy. During 9 years, the annual incidence of DVT following major procedures was 2.1% (95% CI 1.6-2.6) vs. 0.6% (95% CI 0.2-1.1) after diagnostic knee arthroscopy. Symptoms appeared, on average, 27 (3-150) days after total hip replacement surgery, 36 (3-150) days after nailed hip fracture, 17 (6-30) days after total knee replacement and 1 (1-6) day after knee arthroscopy. In hip-operated patients, 50% of the DVTs were found in the proximal veins vs. 40% following knee arthroplasty.
Dahl
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OE
Department of Orthopaedics and Research Forum, Ullevaal University Hospital, Oslo, Norway.
Gudmundsen
T E
TE
Haukeland
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L
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D001182:Arthroscopy / Q000009:adverse effects; D002415:Cats; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects; D006620:Hip Fractures / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*