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Risk factors for deep vein thrombosis even using low-molecular-weight heparin after total knee arthroplasty

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With an increase in deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in the Asian population, most surgeons today use a form of prophylactic anticoagulant agents in patients after TKA. Nevertheless, DVT occasionally develops even in these patients with prophylaxis. The purpose of this study was to identify the risk factors for DVT after TKA in cases of postoperative low-molecular-weight heparin (LMWH) use.We designed a retrospective study with 103 patients who underwent primary TKA. From the second postoperative day, 60 mg of LMWH was subcutaneously injected into the patients daily. On the seventh postoperative day, patients had computed tomography angiography to check whether they had DVT. Regarding risk factors, we investigated patients’ gender, age, surgical site (unilateral/bilateral), body mass index, method of anesthesia, preoperative hypertension, diabetes, hypercholesterolemia status, and prothrombin time/international normalized ratio from electronic medical records. We analyzed the statistical significance of these risk factors. Statistically significant factors in the single-variable analysis were surgical site (unilateral/bilateral), body mass index, preoperative hypertension status, and anesthesia method. Multiple logistic regression analysis with these factors revealed that the surgical site (unilateral/bilateral, p = 0.024) and anesthesia method ( p = 0.039) were significant factors for the occurrence of postoperative DVT after TKA. Patients undergoing simultaneous bilateral TKAs and patients undergoing TKA with general anesthesia need more attention regarding DVT even with chemoprophylaxis using LMWH after TKA.

Abstract

With an increase in deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in the Asian population, most surgeons today use a form of prophylactic anticoagulant agents in patients after TKA. Nevertheless, DVT occasionally develops even in these patients with prophylaxis. The purpose of this study was to identify the risk factors for DVT after TKA in cases of postoperative low-molecular-weight heparin (LMWH) use.We designed a retrospective study with 103 patients who underwent primary TKA. From the second postoperative day, 60 mg of LMWH was subcutaneously injected into the patients daily. On the seventh postoperative day, patients had computed tomography angiography to check whether they had DVT. Regarding risk factors, we investigated patients’ gender, age, surgical site (unilateral/bilateral), body mass index, method of anesthesia, preoperative hypertension, diabetes, hypercholesterolemia status, and prothrombin time/international normalized ratio from electronic medical records. We analyzed the statistical significance of these risk factors. Statistically significant factors in the single-variable analysis were surgical site (unilateral/bilateral), body mass index, preoperative hypertension status, and anesthesia method. Multiple logistic regression analysis with these factors revealed that the surgical site (unilateral/bilateral, p = 0.024) and anesthesia method ( p = 0.039) were significant factors for the occurrence of postoperative DVT after TKA. Patients undergoing simultaneous bilateral TKAs and patients undergoing TKA with general anesthesia need more attention regarding DVT even with chemoprophylaxis using LMWH after TKA.

참고문헌 (41)

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관련 논문AI추천

Incidences of Deep Vein Thrombosis and Pulmonary Embolism after Total Knee Arthroplasty Using a Mechanical Compression Device with and without Low-Molecular-Weight Heparin박신형, 박용복, 안중현, 이선근, 임수재대한슬관절학회 · Knee Surgery and Related Research2016 · 제28권 제3호Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplastyChua Weiliang, Htet Kway Swar, Tan Xin Yang, Wang Wilson, Wang Xinyu, Zhang Siyuan대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권 Prophylaxis for Venous Thromboembolism Following Total Knee Arthroplasty: A Survey of Korean Knee Surgeons전철홍, Jong-Min Kim, Nam Ki Kim, Tae Kyun Kim대한슬관절학회 · Knee Surgery and Related Research2016 · 제28권 제3호Incidence of Venous Thromboembolism Using 64 Channel Multidetector Row Computed Tomography-Indirect Venography and Anti-Coagulation Therapy after Total Knee Arthroplasty in Korea경희수, Ji-Ho Lee, Kyung-Hyun Park, Sang-Ho Cheon대한슬관절학회 · Knee Surgery and Related Research2012 · 제24권 제1호Thromboprophylaxis for Deep Vein Thrombosis and Pulmonary Embolism after Total Joint Arthroplasty in a Low Incidence Population강동근, 김강일, 배대경, 이상학, 조영주, Sumit S. Khurana대한슬관절학회 · Knee Surgery and Related Research2013 · 제25권 제2호Which orally administered antithrombotic agent is most effective for preventing venous thromboembolism after total knee arthroplasty? A propensity score-matching analysis이명철, 한혁수, Jang Seonpyo, Ro Du Hyun, Shin Woo Cheol, Song Min Ku대한슬관절학회 · Knee Surgery and Related Research2021 · 제33권

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