Metabolic Syndrome and the Incidence of Symptomatic Deep Vein Thrombosis Following Total Knee Arthroplasty

• Published in: Journal of rheumatology Vol. 36; no. 10; pp. 2298 - 2301
• Main Authors: GANDHI, Rajiv, RAZAK, Fahad, TSO, Peggy, DAVEY, J. Roderick, MAHOMED, Nizar N
• Format: Journal Article
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-10-2009; Journal of Rheumatology Publishing
• Subjects: Aged; Anticoagulants - therapeutic use; Arthroplasty, Replacement, Knee; Biological and medical sciences; Blood and lymphatic vessels; Body Mass Index; Cardiology. Vascular system; Diseases of the osteoarticular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Humans; Incidence; Logistic Models; Male; Medical sciences; Metabolic diseases; Metabolic Syndrome - complications; Middle Aged; Miscellaneous; Other metabolic disorders; Registries; Retrospective Studies; Risk Factors; Venous Thrombosis - epidemiology; Venous Thrombosis - prevention & control; Endocrinopathy; Total knee arthroplasty; Knee arthroplasty; Rheumatology; Deep vein thrombosis; Metabolic diseases; Cardiovascular disease; Metabolic syndrome; Epidemiology; Venous disease; Incidence; Vascular disease; Symptomatology; Orthopedic surgery; Treatment; Venous thrombosis
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.090282

Objective. We asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic
deep vein thrombosis (DVT) at 3 months followup.
Methods. We reviewed 1460 patients from our joint registry undergoing primary, unilateral TKR between 1998–2006. Demographic variables
of age, sex, comorbidity, and education were retrieved. Metabolic syndrome was defined as body mass index above 30 kg/m 2 , diabetes, hypertension, and hypercholesterolemia. Logistic regression was used to examine the relationship of metabolic
syndrome on the incidence of DVT.
Results. The overall incidence of symptomatic DVT was 4.4% (65/1460). Patients with metabolic syndrome had an increased incidence
of DVT compared to those without metabolic syndrome (15.5% vs 3.4%). Adjusted analysis showed that the risk of symptomatic
DVT in patients with metabolic syndrome was 3.2 times [odds ratio 3.2, 95% CI (1.0,15.4), p = 0.04] the risk in those without
metabolic syndrome.
Conclusion. Hospital protocols developed for prophylactic anticoagulation following TKR should give special consideration to patients
with metabolic syndrome.