title: Venous thromboembolism in Korean patients undergoing major orthopedic surgery: a prospective observational study using computed tomographic (CT) pulmonary angiography and indirect CT venography.
abstract: In patients undergoing major orthopedic surgery, data of deep venous thrombosis (DVT) and pulmonary embolism (PE) are lacking as studied by computed tomographic (CT) pulmonary angiography and indirect CT venography (CTPA-CTV). A prospective observational study was performed for 363 Korean patients undergoing major orthopedic surgery to determine the incidence of venous thromboembolism (VTE), especially proximal DVT and PE. The incidence of VTE was 16.3% (n=59). Of them, 8 patients (2.2%) were symptomatic. The rate of VTE was the highest in patients who underwent total knee replacement (40.4%), followed by hip fracture surgery (16.4%), and total hip replacement (8.7%; P<0.001). The incidence of PE was 6.6% (n=24). Of them, 4 patients (1.1%) were symptomatic. Forty-one patients (11.3%) were in the proximal DVT or PE group. Based on multivariate analysis, total knee replacement and age > or =65 yr were significant risk factors for proximal DVT or PE in patients undergoing major orthopedic surgery (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.1-5.1; P=0.025; and OR, 2.1; 95% CI, 1.0-4.4; P=0.046, respectively). Taken together, the overall incidence of PE was 6.6% and rate of symptomatic PE rate was 1.1%. Knee joint replacement and age > or =65 yr were significant risk factors for proximal DVT or PE.
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Seung-Ick
authors.initials: SI
authors.lastname: Cha
authors.forename: Shin-Yeop
authors.initials: SY
authors.lastname: Lee
authors.forename: Chang-Ho
authors.initials: CH
authors.lastname: Kim
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Jung
authors.forename: Jae-Hyuck
authors.initials: JH
authors.lastname: Yi
authors.forename: Jongmin
authors.initials: J
authors.lastname: Lee
authors.forename: Seung
authors.initials: S
authors.lastname: Huh
authors.forename: Hyun-Joo
authors.initials: HJ
authors.lastname: Lee
authors.forename: Shin-Yoon
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019637:Orthopedic Procedures; D010690:Phlebography; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000601:surgery; D056910:Republic of Korea; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery