Risk factors for pulmonary embolism after hip and knee arthroplasty: a population-based study

Pulmonary embolism (PE) is a cause of death after total hip and knee arthroplasty (THA, TKA). We characterised the patient population suffering from in-hospital PE and identified perioperative risk factors associated with PE using nationally representative data. Data from the National Hospital Disch...

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Bibliographic Details
Published in:International orthopaedics 2009-12, Vol.33 (6), p.1739-1745
Main Authors: Memtsoudis, Stavros G., Besculides, Melanie C., Gaber, Licia, Liu, Spencer, González Della Valle, Alejandro
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Cerebrovascular Disorders - complications
Child
Child, Preschool
Data Collection
Female
Humans
Kidney Diseases - complications
Male
Medicine
Medicine & Public Health
Middle Aged
Obesity - complications
Original Paper
Orthopedics
Patient Discharge - statistics & numerical data
Pulmonary Embolism - epidemiology
Regression Analysis
Reoperation
Respiratory Distress Syndrome - complications
Retrospective Studies
Risk Factors
Sex Factors
United States - epidemiology
Young Adult
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Summary:Pulmonary embolism (PE) is a cause of death after total hip and knee arthroplasty (THA, TKA). We characterised the patient population suffering from in-hospital PE and identified perioperative risk factors associated with PE using nationally representative data. Data from the National Hospital Discharge Survey between 1990 and 2004 on patients who underwent primary or revision THA/TKA in the United States were analysed. Multivariate regression analysis was performed to determine if perioperative factors were associated with increased risk of in-hospital PE. An estimated 6,901,324 procedures were identified. The incidence of in-hospital PE was 0.36%. Factors associated with an increased risk for the diagnosis of PE included: revision THA, female gender, dementia, obesity, renal and cerebrovascular disease. An increased association with PE was found among patients with diagnosis of Adult Respiratory Distress Syndrome (ARDS), psychosis (confusion), and peripheral thrombotic events. Our findings may be useful in stratifying the individual patient’s risk of PE after surgery.
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-008-0659-z