A systematic review-meta-analysis of venous thromboembolic events following primary hip arthroscopy for FAI: clinical and epidemiologic considerations.
A systematic review-meta-analysis of venous thromboembolic events following primary hip arthroscopy for FAI: clinical and epidemiologic considerations.
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DOI：
10.1093/jhps/hny029
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发表时间：
2018-08
影响因子：
1.5
通讯作者：
Philippon MJ
中科院分区：
文献类型：
--
作者：
Bolia IK;Fagotti L;McNamara S;Dornan G;Briggs KK;Philippon MJ
本研究的目的是报告因股骨髋臼撞击（FAI）而接受初次髋关节镜检查的患者中静脉血栓栓塞事件（VTE）的比例，并对文献进行批判性概述，以帮助更好地解释结果。检索了2000年1月至2017年3月的MedLine、Scopus和Web of Science数据库。4577例髋关节病例被纳入38项研究的荟萃分析。患者平均年龄为36 ± 1.8岁，平均随访时间为20.6个月。接受初次髋关节镜手术治疗FAI综合征的患者中深静脉血栓形成（DVT）的荟萃分析率为1.18%; 95%CI [0.8-1.74%];接受初次髋关节镜手术治疗FAI综合征的患者中肺栓塞（PE）的荟萃分析率为0.59%; 95%CI [0.38-0.92%]。使用非随机研究方法学索引（MINORS）标准和预后研究质量（QUIPS）工具进行质量评估。进行敏感性分析，以评估发表偏倚及其对结果的影响。DVT的校正发表偏倚比例为2.02%; 95%CI [1.36-2.99%]。校正偏倚后DVT发生率加倍，同时检测到其他类型的偏倚。在考虑观察性研究的结果以做出临床决策时，必须予以注意。没有足够的证据支持是否应该对因FAI接受初次髋关节镜检查的患者进行抗VTE药物预防。由于这种并发症危及生命的特点，结果应作为设计临床试验和建立指南的起点。在此之前，应在个案基础上决定对静脉血栓栓塞采取预防措施。
The purpose of this study was to report the proportion of venous thromboembolic events (VTE) in patients undergoing primary hip arthroscopy for femoroacetabular impingement (FAI) and present a critical overview of the literature to aid in better result interpretation. MedLine, Scopus and Web of Science databases were searched from January 2000 to March 2017. Four thousand-five-hundred and seventy-seven hip cases were included in the meta-analysis of 38 studies. The mean age of patients was 36 ± 1.8 years and the mean follow-up time was 20.6 months. The meta-analysed rate of deep vein thrombosis (DVT) in patients undergoing primary hip arthroscopy for FAI syndrome was 1.18%; 95%CI [0.8–1.74%]; The meta-analysed rate of pulmonary embolism (PE) in patients undergoing primary hip arthroscopy for FAI syndrome was 0.59%; 95%CI [0.38–0.92%]. Quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria the Quality in Prognostic Studies (QUIPS) tool. Sensitivity analysis was conducted to assess for publication bias and its influence on the results. The corrected for publication bias proportion of DVT was 2.02%; 95%CI [1.36–2.99%]. The DVT rate was double following the correction of bias while additional types of bias were detected. Attention must be paid when considering the outcomes of observational studies to make clinical decisions. Insufficient evidence exists to support whether anti-VTE chemoprophylaxis should be administered to patients undergoing primary hip arthroscopy for FAI. Due to the life-threatening character of this complication, the results should serve as starting point to design clinical trials and establish guidelines. Until then, the application of preventive measures against VTE should be decided on a case-by-case basis.
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影响因子：
4.8
作者：
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通讯作者：
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影响因子：
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DOI：
10.1016/j.arthro.2015.06.028
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影响因子：
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作者：
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