Epidemiology of post-operative venous thromboembolism in Asian patients. Results of the SMART venography study

Service de Pharmacologie Clinique, EA 643, Université de Lyon 1, Lyon, France Correspondence: Alain Leizorovicz, Service de Pharmacologie Clinique, EA 643 Faculté R.T.H. Laennec, Rue Guillaume Paradin BP 8071–69376 Lyon cedex 08, France. E-mail: al{at}upcl.univ-lyon1.fr Background and Objectives: Th...

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Published in:	Haematologica (Roma) Vol. 92; no. 9; pp. 1194 - 1200
Main Authors:	Leizorovicz, Alain, SMART Venography Study Steering Committee
Format:	Journal Article
Language:	English
Published:	Pavia Haematologica 01-09-2007 Ferrata Storti Foundation
Subjects:	Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip Asia Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cohort Studies Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Hematologic and hematopoietic diseases Humans Life Sciences Male Medical sciences Middle Aged Other Phlebography Postoperative Complications Postoperative Period Prospective Studies Risk Factors Time Factors Venous Thromboembolism - epidemiology Venous Thromboembolism - etiology Asia Human Postoperative Asiatic Hematology Deep vein thrombosis Cardiovascular disease Epidemiology Venous disease Vascular disease epidemiological study Orthopedic surgery Treatment Asia venous thromboembolism Venous thrombosis Thromboembolism venography
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Summary:	Service de Pharmacologie Clinique, EA 643, Université de Lyon 1, Lyon, France Correspondence: Alain Leizorovicz, Service de Pharmacologie Clinique, EA 643 Faculté R.T.H. Laennec, Rue Guillaume Paradin BP 8071–69376 Lyon cedex 08, France. E-mail: al{at}upcl.univ-lyon1.fr Background and Objectives: The rate of post-operative asymptomatic deep-vein thrombosis in Asian patients remains uncertain. The aim of this study was to estimate the rate of venous thromboembolism, including asymptomatic deep-vein thrombosis, in Asian patients undergoing hip or knee surgery and not receiving pharmacological thromboprophylaxis. Design and Methods: This was a prospective observational study of a cohort of consecutive Asian patients. The primary study outcome was the composite of venographically detected asymptomatic, or confirmed symptomatic venous thromboembolism, or sudden death at hospital discharge. Bilateral venography was to be performed in all patients between days 5 and 14 after surgery. Follow-up lasted 1 month. Results: A total of 386 patients (median age: 65 years, female: 63.7%, body-mass index =30 kg/m 2 : 15.4%) undergoing hip (n=160) or knee (n=226) replacement surgery satisfied the study selection criteria and 326 (84.5%) had evaluable venograms. The rate of the primary outcome was 36.5% (119 patients, 99% confidence interval: 29.7 to 43.7). The rate of symptomatic venous thromboembolism was 0.9% (3 patients, 99% confidence interval: 0.1 to 3.3). During follow-up (358 patients for a median duration of 33 days after surgery), two additional episodes of symptomatic venous thromboembolism occurred. Multivariate analysis identified that knee replacement surgery, duration of surgery and treatment with antibiotics within 1 week before surgery were independent risk factors ( p <0.05) for venous thromboembolism or sudden death at hospital discharge. Interpretation and Conclusions: In Asian patients, the incidence of asymptomatic and symptomatic venous thromboembolism after major orthopedic surgery is high. These results suggest that thromboprophylaxis should be considered in these patients. Key words: Asia, epidemiological study, orthopedic surgery, venography, venous thromboembolism.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0390-6078 1592-8721
DOI:	10.3324/haematol.10819