Internal Validation of a Risk Scoring System for Venous Thromboembolism After Total hip or Knee Arthroplasty

• Published in: Clinical and applied thrombosis/hemostasis 2022, Vol.28, p.10760296221103868-10760296221103868
• Main Authors: Akamine, Akihiko, Takahira, Naonobu, Kuroiwa, Masayuki, Tomizawa, Atsushi, Atsuda, Koichiro
• Format: Article
• Language: English
• Subjects: Adult; Anticoagulants; Arthroplasty, Replacement, Knee - adverse effects; Case-Control Studies; Humans; Joint replacement surgery; Original Manuscript; Risk Factors; Thromboembolism; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/10760296221103868

We developed a computerized clinical decision support system (CCDSS) for venous thromboembolism (VTE) risk assessment. We aimed to demonstrate its relevance and evaluate associations between risk level and VTE incidence in patients undergoing total hip/knee arthroplasty. In this case-control study, VTE was confirmed using ultrasonography/computed tomography angiography in 1098 adults at a tertiary care hospital over five years (2013-2018). Postoperative VTE incidence was classified into three risk levels (moderate, high, and highest). The overall VTE incidence was 11.7%, which increased with a risk level of 0%, 5.8%, and 12.8% in moderate-risk, high-risk, and highest-risk patients, respectively. Highest-risk patients were significantly more likely to develop VTE than high-risk patients (odds ratio [OR] 2.4; 95% confidence interval [CI] 1.2-5.5; p = 0.01). VTE development was more likely in patients with risk scores ≥4 relative to those with risk scores of 2–3 (OR 1.8; 95% CI 1.2-2.7; p = 0.003) and −1 to 1 (OR 3.3; 95% CI 1.6-7.7; p