PDF(Pubmed)
Abstract：
BACKGROUND: Several risk factors are associated with acute venous thromboembolism (VTE) after total joint arthroplasty (TJA). However, there is a lack of literature regarding the cumulative impact of multiple risk factors. To address this gap, we utilized the PearlDiver database, an insurance billing claims database containing de-identified data from 91 million orthopedic patients.
METHODS: The PearlDiver database was queried for records of patients who underwent total hip and knee arthroplasty from 2010 to 2019 using ICD-10 and CPT codes. Twelve persistent and two transient risk factors were analyzed for their association with the occurrence of acute VTE within three months after surgery. Univariate and logistic regression analyses with odds ratios (ORs) and confidence intervals (CIs) were conducted to determine the odds associated with each risk factor and the impact of multiple concurrent risk factors.
RESULTS: A total of 988,675 patients who underwent hip and knee arthroplasty met the inclusion criteria, of whom 1.5% developed acute VTE after three months. The prevalence of VTE risk factors ranged from 0.2 to 38.6%. Individual, persistent risk factors demonstrated 14-84% increased odds of VTE compared to a 1.2% increase for a transient risk factor (acute myocardial infarction). Three or more persistent risk factors were associated with a higher risk of VTE.
CONCLUSIONS: Persistent risk factors were associated with a higher incidence of postoperative VTE than transient risk factors. An incremental increase in risk was noted if three or more persistent risk factors were present.
METHODS: The PearlDiver database was queried for records of patients who underwent total hip and knee arthroplasty from 2010 to 2019 using ICD-10 and CPT codes. Twelve persistent and two transient risk factors were analyzed for their association with the occurrence of acute VTE within three months after surgery. Univariate and logistic regression analyses with odds ratios (ORs) and confidence intervals (CIs) were conducted to determine the odds associated with each risk factor and the impact of multiple concurrent risk factors.
RESULTS: A total of 988,675 patients who underwent hip and knee arthroplasty met the inclusion criteria, of whom 1.5% developed acute VTE after three months. The prevalence of VTE risk factors ranged from 0.2 to 38.6%. Individual, persistent risk factors demonstrated 14-84% increased odds of VTE compared to a 1.2% increase for a transient risk factor (acute myocardial infarction). Three or more persistent risk factors were associated with a higher risk of VTE.
CONCLUSIONS: Persistent risk factors were associated with a higher incidence of postoperative VTE than transient risk factors. An incremental increase in risk was noted if three or more persistent risk factors were present.
摘要：
背景：多种危险因素与全关节置换术（TJA）后的急性静脉血栓栓塞（VTE）相关。然而,缺乏关于多个危险因素的累积影响的文献.为了解决这个差距，我们利用了PearlDiver数据库,包含来自9100万骨科患者的去识别数据的保险账单索赔数据库。
方法：使用ICD-10和CPT代码查询PearlDiver数据库中2010年至2019年接受全髋关节和膝关节置换术患者的记录。分析了12种持续性和2种暂时性危险因素与术后3个月内发生急性VTE的关系。使用比值比（ORs）和置信区间（CIs）进行单变量和逻辑回归分析，以确定与每个风险因素相关的几率以及多个并发风险因素的影响。
结果：共有988,675例接受髋和膝关节置换术的患者符合纳入标准，其中1.5%在三个月后发生急性VTE。VTE危险因素的患病率为0.2％至38.6％。个人,持续性危险因素显示发生VTE的几率增加14-84%,而短暂性危险因素(急性心肌梗死)增加1.2%.三个或更多的持续性危险因素与较高的VTE风险相关。
结论：持续危险因素与术后静脉血栓栓塞的发生率高于短暂危险因素。如果存在三个或更多的持续风险因素，则注意到风险增加。
方法：使用ICD-10和CPT代码查询PearlDiver数据库中2010年至2019年接受全髋关节和膝关节置换术患者的记录。分析了12种持续性和2种暂时性危险因素与术后3个月内发生急性VTE的关系。使用比值比（ORs）和置信区间（CIs）进行单变量和逻辑回归分析，以确定与每个风险因素相关的几率以及多个并发风险因素的影响。
结果：共有988,675例接受髋和膝关节置换术的患者符合纳入标准，其中1.5%在三个月后发生急性VTE。VTE危险因素的患病率为0.2％至38.6％。个人,持续性危险因素显示发生VTE的几率增加14-84%,而短暂性危险因素(急性心肌梗死)增加1.2%.三个或更多的持续性危险因素与较高的VTE风险相关。
结论：持续危险因素与术后静脉血栓栓塞的发生率高于短暂危险因素。如果存在三个或更多的持续风险因素，则注意到风险增加。
