Background Orthopaedic surgery is associated with a high risk of venous thromboembolism events (VTE), especially in total hip arthroplasty (THA) or total knee arthroplasty (TKA). The incidence of VTE with pharmacological prophylaxis after THA or TKA was 0.7%.1 Although this incidence is low, these adverse events are serious and usually preventable.
Purpose The aims of this study were to evaluate the incidence of VTE and the factors associated with a VTE after THA or TKA.
Material and methods To evaluate this incidence in 2017, the numerator (number of stays with VTE after THA or TKA) and the denominator (number of stays of patients hospitalised to THA or TKA) were obtained from diagnosis related groups (DRG) data. Some demographic and medical characteristics of stays were extracted from DRG data. Information related to the thromboprophylaxis were obtained by analysing prescriptions of the whole stays. The factors associated with a VTE were identified according to Fisher’s exact test.
Results A total of 833 stays of THA and TKA were identified. The patients’ mean age was 72.2 years. The most common thromboprophylaxis was the use of low-molecular weight heparin (LMWH) in postoperative and rivaroxaban over the following days.
The incidence of VTE was 0.48%. The patients’ mean age with VTE was 74 years. The most common thromboprophylaxis was the use of LMWH in postoperative and dabigatran. In the study, any factors were not significantly associated with VTE (p>0.05).
Conclusion In our study, the incidence was low. Our prescription software proposed protocols of thromboprophylaxis standardised according to patients’ characteristics, especially age. The prescriptions were always performed by senior physicians. The thromboprophylaxis recommendations were respected. This study did not find characteristics significantly associated with VTE. It could be interesting to perform a national study to identify the factors associated with VTE after THA or TKA. This will allow the establishment of corrective measures to improve patient care and share professional and organisational practices of hospitals with low incidence of VTE.
References and/or acknowledgements 1. Senay A, et al. Incidence of symptomatic venous thromboembolism in 2372 knee and hip replacement patients after discharge: data from a thromboprophylaxis registry in Montreal, Canada. Vasc Health Risk Manag 2018;
No conflict of interest.