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  • Title: Perioperative risk factors for deep vein thrombosis after total hip arthroplasty or total knee arthroplasty.
    Author: Shimoyama Y, Sawai T, Tatsumi S, Nakahira J, Oka M, Nakajima M, Jotoku T, Minami T.
    Journal: J Clin Anesth; 2012 Nov; 24(7):531-6. PubMed ID: 23006595.
    Abstract:
    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 μg/mL. CONCLUSIONS: A high preoperative plasma D-dimer value and/or history of hyperlipidemia were risk factors for DVT after THA or TKA.
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