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Venous thromboembolism after major orthopaedic surgery: a population-based cohort study

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Abstract

Venous thromboembolism (VTE) is an important cause of morbidity and mortality following major orthopaedic surgery. However, the incidence of VTE and the role of additional risk factors have not yet been well explored in Italian clinical practice. The objective of the study is to estimate the incidence of VTE in the 3 months following elective hip and knee replacement (HR, KR) in a large cohort of patients, and the association between some selected risk factors and the occurrence of VTE. A large cohort study based on the record linkage between automated archives of the National Health System was analysed. In particular, all the residents in the Lombardy Region (Italy) who underwent HR and KR between 2005 and 2008 were followed for 3 months after surgery. The odds ratio (OR) of VTE associated with selected known risk factors was estimated by multivariate logistic regression. Amongst the 69,770 patients included in the study, 2,393 experienced at least one VTE event during the follow-up; the overall risk of VTE after HR or KR was 3.4%. The adjusted odds of experiencing a VTE event was higher in male patients (OR 1.11; 95% confidence interval 1.01–1.21), aged 60 years or older (1.30; 1.00–1.68), undergoing KR (1.47; 1.35–1.61), with previous deep vein thrombosis (1.96; 1.20–3.19), pulmonary embolism (3.25; 1.84–5.75) or cancer (1.21; 1.00–1.46). In conclusion, the incidence of VTE after elective HR and KR in the Italian clinical practice is high. Our results suggest the need of optimising the management of thromboprophylaxis to further reduce postoperative VTE.

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Acknowledgments

This study was supported by an unrestricted educational grant by Bayer.

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Authors and Affiliations

  1. Internal Medicine Department, University Hospital of Ferrara, University Hospital, S. Anna Corso Giovecca 203, 44100, Ferrara, Italy

    Davide Imberti & Massimo Gallerani

  2. Pricing and HEOR, Bayer Schering Pharma, Milan, Italy

    Cosetta Bianchi

  3. Unit of Biostatistics and Epidemiology, Department of Statistics, University of Milano-Bicocca, Milan, Italy

    Antonella Zambon, Andrea Parodi & Giovanni Corrao

  4. Operative Unit of Territorial Health Services, Region of Lombardy, Milan, Italy

    Luca Merlino

Authors
  1. Davide Imberti
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  2. Cosetta Bianchi
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  3. Antonella Zambon
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  4. Andrea Parodi
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  5. Luca Merlino
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  6. Massimo Gallerani
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  7. Giovanni Corrao
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Correspondence to Davide Imberti.

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Imberti, D., Bianchi, C., Zambon, A. et al. Venous thromboembolism after major orthopaedic surgery: a population-based cohort study. Intern Emerg Med 7, 243–249 (2012). https://doi.org/10.1007/s11739-011-0567-x

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  • DOI: https://doi.org/10.1007/s11739-011-0567-x

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