VTE Rates Post Knee Arthroplasty Increased '97-'07

Risk is higher among patients with cardiovascular disease or history of venous thromboembolism

THURSDAY, July 28 (HealthDay News) -- The rate of venous thromboembolism following knee arthroplasty has increased from 1997 to 2007, with a higher risk among patients with a history of cardiovascular disease or a prior venous thromboembolism, according to a study published in the July 20 issue of The Journal of Bone & Joint Surgery.

Alma B. Pedersen, M.D., Ph.D., from the Aarhus University Hospital in Denmark, and colleagues assessed the rate and changes over time of symptomatic venous thromboembolism events among 37,223 patients who underwent primary knee arthroplasties with pharmacological thromboprophylaxis in Denmark, between 1997 and 2007. Hospitalization with symptomatic venous thromboembolism within 90 days of surgery was the primary outcome.

The investigators found that the overall hospitalization rate for venous thromboembolism was 1.2 percent at an average of 15 days. The hospitalization rate was 0.9 percent for deep venous thrombosis and 0.3 percent for pulmonary embolism, with nine patients who had both. During the 10 years of study, the rate of venous thromboembolism increased, with an increased risk among patients with a higher score on the Charlson comorbidity index (adjusted relative risk, 1.73). A higher risk for postoperative venous thromboembolism was found among patients with a history of cardiovascular disease or a prior venous thromboembolism, compared to patients without these conditions.

"Despite pharmacological thromboprophylaxis, patients undergoing knee arthroplasty remain susceptible for venous thromboembolism events after surgery. Future efforts should focus on the improvement of prophylaxis following hospital discharge, particularly among elderly patients and those with a history of cardiovascular diseases or previous venous thromboembolism," the authors write.

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