title: Venous thromboembolism after elective shoulder surgery: a prospective cohort study of 175 patients.
abstract: BACKGROUND
  The purpose of this study was to investigate the incidence of venous thromboembolism (VTE) after elective arthroscopic shoulder surgery.
  
  
  METHODS
  One hundred seventy-five consecutive patients who underwent arthroscopic shoulder surgery were enrolled (mean age, 61 years). Patients who had VTE preoperatively and underwent trauma surgery or arthroplasty were excluded. All the patients used foot pumps or elastic stockings after surgery for deep venous thrombosis (DVT) prophylaxis. DVT in the 4 limbs was assessed by ultrasound before and after surgery. Pulmonary embolism was diagnosed by computed tomography pulmonary angiography. Risk factors related to DVT were assessed.
  
  
  RESULTS
  The overall incidence of DVT was 10 of 175 patients (5.7%). Most of the DVT cases were detected at 1 to 2 days after surgery. All patients were asymptomatic. There were no patients who had symptomatic pulmonary embolism. However, an asymptomatic pulmonary embolus developed in 1 patient during the 3-month follow-up period. There were no significant differences between the DVT and non-DVT groups regarding the risk factors.
  
  
  CONCLUSIONS
  Our data have shown that symptomatic VTE is rare after elective arthroscopic shoulder surgery. However, asymptomatic VTE may occur even with DVT preventive measures. Because most of the DVTs were found in the calf veins, we recommend that surgeons pay attention to the possibility of DVT in the lower extremities even after arthroscopic shoulder surgery. The incidence of asymptomatic VTE after elective arthroscopic shoulder surgery was 5.7%. All patients were asymptomatic, and most of the DVTs occurred 1 or 2 days after surgery.
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nagamoto
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan. Electronic address: itoi-eiji@med.tohoku.ac.jp.
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology; D012307:Risk Factors; D012785:Shoulder Joint / Q000601:surgery*; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult
keywords: Venous thromboembolism; arthroscopy; asymptomatic; deep venous thrombosis; pulmonary embolism; shoulder surgery; ultrasonography