Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty

Background Venous thromboembolic events (VTEs) are common after total knee arthroplasty (TKA). The rate of VTEs has improved with early mobilization, mechanical prophylaxis, and appropriate chemoprophylaxis. The aim of this study was to analyze the contribution of medical comorbidities to the risk o...

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Autores principales:	Abiram Bala MD, Kingsley Oladeji MD, Derek F. Amanatullah MD, PhD
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Orthopedic surgery RD701-811 Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/864d2640f4924f42b8715711da933533
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spelling	oai:doaj.org-article:864d2640f4924f42b8715711da9335332021-11-24T05:03:20ZEffect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty2151-459310.1177/21514593211043998https://doaj.org/article/864d2640f4924f42b8715711da9335332021-10-01T00:00:00Zhttps://doi.org/10.1177/21514593211043998https://doaj.org/toc/2151-4593Background Venous thromboembolic events (VTEs) are common after total knee arthroplasty (TKA). The rate of VTEs has improved with early mobilization, mechanical prophylaxis, and appropriate chemoprophylaxis. The aim of this study was to analyze the contribution of medical comorbidities to the risk of VTE after TKA Method Medicare claims from 2005 to 2014 were queried. International Classification of Diseases, Ninth revision (ICD-9), and Current Procedural Terminology codes were used to identify the diagnoses, procedures, and complications. 157,200 primary TKAs were age, sex, and Elixhauser Comorbidity Index (ECI) matched with 157,200 osteoarthritis controls. First instances of deep venous thrombosis (DVT) and pulmonary embolism were tracked at 90 days and 2 years. Odds ratios (ORs), confidence intervals, and P -values (p) were calculated and used to investigate the contribution of comorbidities. Results 90 days after TKA or OA diagnosis, comorbidities were associated with 45% of the DVT risk, 38% of the PE risk. 1 in 92 patients would be expected to be diagnosed with VTE after TKA and 1 in 136 patients after only the diagnosis of osteoarthritis. After 90 days, medical comorbidities were associated with 70% of the DVT risk, 68% of the PE risk. Conclusion Nearly 50% of DVTs and 40% of PEs within 90 days of TKA may be related to the baseline health of OA patients. Venous thromboembolic events after TKA are a “never” event according to Center of Medicare and services that appropriate VTE prophylaxis likely cannot be neutralized.Abiram Bala MDKingsley Oladeji MDDerek F. Amanatullah MD, PhDSAGE PublishingarticleOrthopedic surgeryRD701-811GeriatricsRC952-954.6ENGeriatric Orthopaedic Surgery & Rehabilitation, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811 Geriatrics RC952-954.6
spellingShingle	Orthopedic surgery RD701-811 Geriatrics RC952-954.6 Abiram Bala MD Kingsley Oladeji MD Derek F. Amanatullah MD, PhD Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
description	Background Venous thromboembolic events (VTEs) are common after total knee arthroplasty (TKA). The rate of VTEs has improved with early mobilization, mechanical prophylaxis, and appropriate chemoprophylaxis. The aim of this study was to analyze the contribution of medical comorbidities to the risk of VTE after TKA Method Medicare claims from 2005 to 2014 were queried. International Classification of Diseases, Ninth revision (ICD-9), and Current Procedural Terminology codes were used to identify the diagnoses, procedures, and complications. 157,200 primary TKAs were age, sex, and Elixhauser Comorbidity Index (ECI) matched with 157,200 osteoarthritis controls. First instances of deep venous thrombosis (DVT) and pulmonary embolism were tracked at 90 days and 2 years. Odds ratios (ORs), confidence intervals, and P -values (p) were calculated and used to investigate the contribution of comorbidities. Results 90 days after TKA or OA diagnosis, comorbidities were associated with 45% of the DVT risk, 38% of the PE risk. 1 in 92 patients would be expected to be diagnosed with VTE after TKA and 1 in 136 patients after only the diagnosis of osteoarthritis. After 90 days, medical comorbidities were associated with 70% of the DVT risk, 68% of the PE risk. Conclusion Nearly 50% of DVTs and 40% of PEs within 90 days of TKA may be related to the baseline health of OA patients. Venous thromboembolic events after TKA are a “never” event according to Center of Medicare and services that appropriate VTE prophylaxis likely cannot be neutralized.
format	article
author	Abiram Bala MD Kingsley Oladeji MD Derek F. Amanatullah MD, PhD
author_facet	Abiram Bala MD Kingsley Oladeji MD Derek F. Amanatullah MD, PhD
author_sort	Abiram Bala MD
title	Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
title_short	Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
title_full	Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
title_fullStr	Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
title_full_unstemmed	Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
title_sort	effect of comorbidity burden on the risk of venous thromboembolic events after total knee arthroplasty
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/864d2640f4924f42b8715711da933533
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Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty

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