Venous Thromboembolism in Podiatric Foot and Ankle Surgery

Background: The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thrombopro...

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Bibliographic Details
Published in:Foot and ankle specialist 2018-10, Vol.11 (5), p.444-450
Main Authors: Matthews, Jemma H., Terrill, Alexander J., Barwick, Alex L., Butterworth, Paul A.
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Ankle - surgery
Australia
Cohort Studies
Female
Foot - surgery
Humans
Incidence
Logistic Models
Male
Middle Aged
Orthopedic Procedures - adverse effects
Orthopedic Procedures - methods
Podiatry - methods
Retrospective Studies
Risk Assessment
Sex Distribution
Venous Thromboembolism - epidemiology
Venous Thromboembolism - etiology
Venous Thromboembolism - physiopathology
Young Adult
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Summary:Background: The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thromboprophylaxis. Methods: Data from 4238 patients who underwent foot and ankle surgery over 2 years were analyzed. Venous thromboembolism within the first 30 days following surgery was recorded using the Australasian College of Podiatric Surgeons surgical audit tool. Logistic regression analyses were undertaken to determine the factors that influenced thromboprophylaxis. Results: Of the 4238 patient records, 3677 records (87%) provided complete data (age range 2-94 years; mean ± SD, 49.1 ± 19.7 years; 2693 females). A total of 7 venous thromboembolic events (0.2% rate) were reported. Operative duration and age (OR 12.63, 95% CI 9.47 to 16.84, P < 0.01), postoperative immobilization (OR 6.94, 95% CI 3.95 to 12.20, P < 0.01), and a prior history of VTE (OR 3.41, 95% CI 1.01 to 11.04, P = 0.04) were the strongest predictors of thromboprophylaxis. Conclusion: Podiatric foot and ankle surgery is associated with a low rate of venous thromboembolism. This may be due in part to the thromboprophylaxis regime implemented by podiatric surgeons, which closely aligns with current evidence-based guidelines. Levels of Evidence: Level II: Prospective cohort study
ISSN:1938-6400
1938-7636
DOI:10.1177/1938640017750256