title: Venous Thromboembolism Following Hip and Knee Replacement Arthroplasty in Korea: A Nationwide Study Based on Claims Registry.
abstract: The aim of this study was to examine the incidence and trends of clinically relevant venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee replacement arthroplasty (HKRA) in Korea. Between January 1 and December 31, 2010, 22,127 hip replacement arthroplasty (HRA) patients and 52,882 knee replacement arthroplasty (KRA) patients were enrolled in the analysis using the administrative claims database of the Health Insurance Review and Assessment Service (HIRA). All available parameters including procedure history and clinically relevant VTE during the 90 days after HKRA were identified based on diagnostic and electronic data interchange (EDI) codes. The overall incidence of VTE, DVT, and PE during the 90 days was 3.9% (n=853), 2.7% (n=597), and 1.5% (n=327) after HRA, while the incidence was 3.8% (n=1,990), 3.2% (n=1,699), and 0.7% (n=355) after KRA. The incidence of VTE after HKRA was significantly higher in patients who had previous VTE history (odds ratio [OR], 10.8 after HRA, OR, 8.5 after KRA), chronic heart failure (2.1, 1.3), arrhythmia (1.8, 1.7), and atrial fibrillation (3.4, 2.1) than in patients who did not. The VTE incidence in patients with chemoprophylaxis was higher than that in patients without chemoprophylaxis. The incidence of VTEs revealed in this retrospective review was not low compared with the results of the studies targeting other Asian or Caucasian populations. It may warrant routine prevention including employment of chemoprophylaxis. However, the limitation of the reviewed data mandates large scale prospective investigation to affirm this observation.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sahnghoon
authors.identifier: 0000-0003-0725-185X
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Nursing Management, Kyung Hee University College of Nursing Science, Seoul, Korea.
authors.forename: Jee-In
authors.identifier: 0000-0003-2284-5795
authors.initials: JI
authors.lastname: Hwang
authors.affiliation: Office of Health Services Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea.
authors.forename: Yunjung
authors.identifier: 0000-0002-0449-1279
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Pil Whan
authors.identifier: 0000-0001-7354-0989
authors.initials: PW
authors.lastname: Yoon
authors.affiliation: Office of Health Services Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea.
authors.forename: Jeonghoon
authors.identifier: 0000-0002-0177-0192
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.; Office of Health Services Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea.
authors.forename: Jeong Joon
authors.identifier: 0000-0002-6304-0101
authors.initials: JJ
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology
keywords: Chemoprophylaxis; Hip; Knee; Korea; Replacement Arthroplasty; Venous Thromboembolism