Perioperative risk factors for deep vein thrombosis after total hip arthroplasty or total knee arthroplasty

详细信息    查看全文

• 作者：Yuichiro Shimoyama ; MD^a (Assistant Professor of Anesthesia) ; Toshiyuki Sawai ; MD ; PhD^a ; ^{ane026@poh.osaka-med.ac.jp} (Junior Associate Professor of Anesthesia) ; Shinichi Tatsumi ; MD ; PhD^a (Assistant Professor of Anesthesia) ; Junko Nakahira ; MD ; PhD^a (Assistant Professor of Anesthesia) ; Masayuki Oka ; MD^a (Assistant Professor of Anesthesia) ; Mikio Nakajima ; MD ; PhD^b (Associate Professor of Orthopedic Surgery) ; Tsuyoshi Jotoku ; MD ; PhD^b (Assistant Professor of Orthopedic Surgery) ; Toshiaki Minami ; MD ; PhD^a (Professor of Anesthesia)
• 关键词：Deep vein thrombosis ; Plasma D-dimer ; Plasma hyperlipidemia ; Total hip arthroplasty ; Total knee arthroplasty ; Ultrasonography
• 刊名：Journal of Clinical Anesthesia
• 出版年：2012
• 出版时间：November, 2012
• 年：2012
• 卷：24
• 期：7
• 页码：531-536
• 全文大小：190 K

文摘

Study Objective

To determine the perioperative frequency of deep vein thrombosis (DVT) after lower limb joint prosthesis surgery using Doppler ultrasonography (US).

Design

Prospective cohort study.

Setting

Operating room and hospital ward.

Patients

144 consecutive ASA physical status 1 and 2 patients who underwent elective total hip arthroplasty (THA; n=64) or total knee arthroplasty (TKA; n = 80).

Interventions

Patients were allocated to two groups, those who developed DVT (DVT group) postoperatively and those who did not (no-DVT group). To examine the perioperative risk factors for DVT after THA or TKA, comparative analysis of the two groups was done.

Measurements

Doppler US was performed on all patients from the bilateral femoral to lower limb to detect the existence of DVT postoperatively.

Main Results

DVT was detected in 61 patients (42 % ), including three proximal DVT patients (2 % ). Preoperative elevated plasma D-dimer value [P = 0.0131, odds ratio (OR) 1.54, 95 % CI 1.10-2.17] and history of hyperlipidemia (P = 0.0453, OR 6.92, 95 % CI 1.04-46.00] were significant risk factors for the onset of DVT. A preoperative plasma D-dimer cutoff value as a diagnostic test was obtained as 0.85 ¦Ìg/mL.

Conclusions

A high preoperative plasma D-dimer value and/or history of hyperlipidemia were risk factors for DVT after THA or TKA.