Venous Thromboembolism Seen After 1% of Hip Replacements

Factors linked to higher risk include osteoarthritis, history of CVD, prior thromboembolism
By Eric Metcalf
HealthDay Reporter

THURSDAY, Sept. 23 (HealthDay News) -- Venous thromboembolism following total hip replacement occurs in roughly 1 percent of patients who receive pharmacological thromboprophylaxis, and factors associated with increased risk of venous thromboembolism include osteoarthritis, a history of cardiovascular disease, and previous thromboembolism, according to research published in the Sept. 15 issue of the Journal of Bone & Joint Surgery.

Alma B. Pedersen, M.D., of the Aarhus University Hospital in Denmark, and colleagues analyzed data from the Danish Hip Arthroplasty Register on 67,469 primary unilateral total hip replacements performed from 1995 through 2006. All patients received pharmacological thromboprophylaxis. The outcome measure was hospitalization with venous thromboembolism within 90 days of the replacement.

The researchers found that the rate of hospitalization was 1.02 percent, which occurred at a median of 22 days. The incidence of symptomatic deep venous thrombosis was 0.7 percent, and the incidence of nonfatal pulmonary embolism was 0.3 percent. Individuals with rheumatoid arthritis had a lower risk of venous thromboembolism compared to those with primary osteoarthritis (adjusted relative risk, 0.47). Factors linked to higher risk were high score on the Charlson comorbidity index, history of cardiovascular disease, and prior venous thromboembolism.

"The overall incidence of venous thromboembolism did not decline during the 10-year study period. Several risk factors for venous thromboembolism were identified," the authors write. "This knowledge can be used in the future to better stratify patients having a total hip replacement according to the risk for venous thromboembolism and to target specific thromboprophylaxis modalities to these patients."

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