Metabolic Syndrome and the Incidence of Symptomatic Deep Vein Thrombosis Following Total Knee Arthroplasty
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 1998â2006. D...
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| Published in: | Journal of rheumatology Vol. 36; no. 10; pp. 2298 - 2301 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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Toronto, ON
The Journal of Rheumatology
01-10-2009
Journal of Rheumatology Publishing |
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| Abstract | 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 1998â2006. 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. |
|---|---|
| AbstractList | 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 1998â2006. 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. OBJECTIVEWe 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.METHODSWe 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.RESULTSThe 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.CONCLUSIONHospital protocols developed for prophylactic anticoagulation following TKR should give special consideration to patients with metabolic syndrome. 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. 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. 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. Hospital protocols developed for prophylactic anticoagulation following TKR should give special consideration to patients with metabolic syndrome. |
| Author | PEGGY TSO J. RODERICK DAVEY RAJIV GANDHI FAHAD RAZAK NIZAR N. MAHOMED |
| Author_xml | – sequence: 1 givenname: Rajiv surname: GANDHI fullname: GANDHI, Rajiv organization: Division of Orthopedic Surgery, University of Toronto, Toronto, Canada – sequence: 2 givenname: Fahad surname: RAZAK fullname: RAZAK, Fahad organization: Division of Orthopedic Surgery, University of Toronto, Toronto, Canada – sequence: 3 givenname: Peggy surname: TSO fullname: TSO, Peggy organization: Division of Orthopedic Surgery, University of Toronto, Toronto, Canada – sequence: 4 givenname: J. Roderick surname: DAVEY fullname: DAVEY, J. Roderick organization: Division of Orthopedic Surgery, University of Toronto, Toronto, Canada – sequence: 5 givenname: Nizar N surname: MAHOMED fullname: MAHOMED, Nizar N organization: Division of Orthopedic Surgery, University of Toronto, Toronto, Canada |
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| Keywords | 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 |
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| References_xml | – volume: 23 start-page: 327 year: 2008 ident: 2018112909212714000_36.10.2298.35 article-title: Metabolic syndrome increases the risk for pulmonary embolism after joint arthroplasty publication-title: J Arthroplasty doi: 10.1016/j.arth.2008.01.281 contributor: fullname: Parvizi – ident: 2018112909212714000_36.10.2298.10 doi: 10.1136/bmj.303.6802.543 – ident: 2018112909212714000_36.10.2298.23 doi: 10.1016/j.metabol.2007.09.002 – ident: 2018112909212714000_36.10.2298.34 doi: 10.1053/j.ajkd.2008.01.013 – ident: 2018112909212714000_36.10.2298.39 doi: 10.1016/0883-5403(94)90103-1 – ident: 2018112909212714000_36.10.2298.15 doi: 10.1385/ENDO:29:1:109 – ident: 2018112909212714000_36.10.2298.24 doi: 10.3324/haematol.10828 – ident: 2018112909212714000_36.10.2298.13 doi: 10.1161/01.CIR.0000046771.12875.6C – ident: 2018112909212714000_36.10.2298.32 doi: 10.1097/00000542-200309000-00009 – ident: 2018112909212714000_36.10.2298.1 doi: 10.1378/chest.119.1_suppl.132S – ident: 2018112909212714000_36.10.2298.27 doi: 10.1016/0021-9681(87)90171-8 – ident: 2018112909212714000_36.10.2298.4 doi: 10.1302/0301-620X.81B5.10316 – ident: 2018112909212714000_36.10.2298.20 doi: 10.1001/jama.286.3.327 – ident: 2018112909212714000_36.10.2298.22 doi: 10.1038/oby.2008.7 – ident: 2018112909212714000_36.10.2298.38 doi: 10.1097/00003086-199811000-00018 – ident: 2018112909212714000_36.10.2298.2 doi: 10.1378/chest.114.2_Supplement.115S – ident: 2018112909212714000_36.10.2298.9 doi: 10.1016/S0140-6736(69)90002-6 – ident: 2018112909212714000_36.10.2298.33 doi: 10.1378/chest.128.5.3364 – volume: 8 start-page: 365 year: 2002 ident: 2018112909212714000_36.10.2298.31 article-title: Risk Factors for venous thromboembolism after total hip and knee replacement surgery publication-title: Curr Opin Rheum contributor: fullname: White – ident: 2018112909212714000_36.10.2298.36 doi: 10.2106/JBJS.D.03033 – ident: 2018112909212714000_36.10.2298.8 doi: 10.1378/chest.102.4_Supplement.391S – ident: 2018112909212714000_36.10.2298.28 – ident: 2018112909212714000_36.10.2298.40 doi: 10.1111/j.1538-7836.2007.02571.x – ident: 2018112909212714000_36.10.2298.21 doi: 10.1161/01.CIR.0000136581.59584.0E – volume: 288 start-page: 219 year: 1993 ident: 2018112909212714000_36.10.2298.12 article-title: Pulmonary embolism in total joint arthroplasty publication-title: Clin Orthop Relat Res doi: 10.1097/00003086-199303000-00029 contributor: fullname: Wolf – volume: 41 start-page: 368 year: 1998 ident: 2018112909212714000_36.10.2298.37 article-title: Accuracy of screening compression ultrasonography and clinical examination for the diagnosis of deep vein thrombosis after total hip or knee arthroplasty publication-title: Can J Surg contributor: fullname: Robinson – ident: 2018112909212714000_36.10.2298.18 doi: 10.1210/jc.83.8.2907 – ident: 2018112909212714000_36.10.2298.3 doi: 10.1080/00016470052943883 – volume: 76 start-page: 1239 year: 1994 ident: 2018112909212714000_36.10.2298.7 article-title: Prevention of venous thromboembolism after total hip and knee arthroplasty publication-title: J Bone Joint Surg Am doi: 10.2106/00004623-199408000-00015 contributor: fullname: Lieberman – ident: 2018112909212714000_36.10.2298.6 doi: 10.1001/archinte.158.14.1525 – ident: 2018112909212714000_36.10.2298.16 doi: 10.1210/jc.2004-0372 – volume: 108 start-page: 279 year: 2007 ident: 2018112909212714000_36.10.2298.26 article-title: Prothrombotic state in metabolic syndrome publication-title: Bratisl Lek Listy contributor: fullname: Durina – ident: 2018112909212714000_36.10.2298.14 doi: 10.1378/chest.128.5.3364 – volume: 280 start-page: E745 year: 2001 ident: 2018112909212714000_36.10.2298.17 article-title: Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance publication-title: Am J Physiol contributor: fullname: Kern – ident: 2018112909212714000_36.10.2298.29 doi: 10.1161/01.ATV.0000112379.88385.67 – ident: 2018112909212714000_36.10.2298.25 doi: 10.1111/j.1538-7836.2006.02132.x – volume: 276 start-page: 222 year: 1992 ident: 2018112909212714000_36.10.2298.11 article-title: Fatal pulmonary embolism after total hip arthroplasty. Seasonal variation publication-title: Clin Orthop Relat Res doi: 10.1097/00003086-199203000-00030 contributor: fullname: Wroblewski – volume: 5 start-page: 1833 year: 1988 ident: 2018112909212714000_36.10.2298.30 article-title: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee publication-title: J Rheumatol contributor: fullname: Bellamy – volume: 20 start-page: 1201 year: 2000 ident: 2018112909212714000_36.10.2298.5 article-title: CT diagnosis of pulmonary embolism and deep venous thrombosis publication-title: RadioGraphics doi: 10.1148/radiographics.20.4.g00jl161201 contributor: fullname: Goodman – ident: 2018112909212714000_36.10.2298.19 doi: 10.1038/oby.2001.54 |
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| Snippet | Objective. We asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic
deep vein thrombosis... We asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic deep vein thrombosis (DVT) at 3... OBJECTIVEWe asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic deep vein thrombosis (DVT)... |
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| SubjectTerms | 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 |
| Title | Metabolic Syndrome and the Incidence of Symptomatic Deep Vein Thrombosis Following Total Knee Arthroplasty |
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