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.
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.
Miyagi
Jin
J
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan.
Funabashi
Nobusada
N
Suzuki
Masahiko
M
Asano
Miki
M
Kuriyama
Takayuki
T
Komuro
Issei
I
Moriya
Hideshige
H
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*
D006454:Hemoglobins