title: Predictive indicators of deep venous thrombosis and pulmonary arterial thromboembolism in 54 subjects after total knee arthroplasty using multislice computed tomography in logistic regression models.
abstract: OBJECTIVE
  To determine predictors of deep venous thrombosis (DVT) in the lower extremities and pulmonary arterial thromboembolism (PE) after total knee arthroplasty (TKA), we evaluated the incidence of these events using multislice computed tomography (CT).
  
  
  METHODS
  54 subjects (10 males, 53-81 years old, the first consecutive 25 receiving anticoagulant therapy) underwent enhanced multislice CT (MSCT) before and one week after TKA.
  
  
  RESULTS
  DVT, PE, and both were detected in twelve, twelve, and three subjects, respectively, one week after TKA. Hemoglobin and alveolar-arterial oxygen gradient (AaDO2) on the day after TKA, and total amount of operative bleeding (TAOB) were significantly higher in subjects with DVT or PE (P<0.05). In a logistic model for predicting DVT or PE, hemoglobin and AaDO2 levels on the day after TKA and TAOB were associated with an increased incidence of DVT or PE (relative risks 3.51, 1.19 and 1.01 (P<0.05), respectively). From box and whisker plots, we speculated the significant border to predict DVT or PE as 10.5 g/dl for hemoglobin, 34 Torr for AaDO2, and 1280 ml for TAOB. These factors also predicted DVT or PE (relative risks 5.08 (hemoglobin more than 10.5), 6.25 (AaDO2 more than 34 Torr), and 4.95 (TAOB more than 1280 ml) (P<0.05)).
  
  
  CONCLUSIONS
  The incidence of DVT or PE one week after TKA was 39% by MSCT. High levels of TAOB, hemoglobin and AaDO2 on the day after TKA may be predictive indicators of DVT or PE one week after TKA.
authors.affiliation: Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Miyagi
authors.forename: Nobusada
authors.initials: N
authors.lastname: Funabashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Miki
authors.initials: M
authors.lastname: Asano
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kuriyama
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
authors.forename: Hideshige
authors.initials: H
authors.lastname: Moriya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006454:Hemoglobins; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*
chemical_list: D006454:Hemoglobins