Venous thromboembolic events following foot and ankle surgery in the English National Health Service
Venous thromboembolic events following foot and ankle surgery in the English National Health Service
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DOI：
10.1302/0301-620x.93b4.25731
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发表时间：
2011-04-01
影响因子：
--
通讯作者：
Reed, M. R.
中科院分区：
文献类型：
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作者：
Jameson, S. S.;Augustine, A.;Reed, M. R.
诊断和手术代码是定期收集的每一个病人入院在英国国民保健服务。足部和踝关节手术后并发症的数据以前没有大量可用。从42个月内接受踝关节骨折固定、第一跖骨截骨术、后足融合术和全踝关节置换术的患者中提取90天内症状性静脉血栓栓塞事件和死亡率的数据。踝关节骨折手术（45949例），深静脉血栓形成（DVT），肺栓塞和死亡率分别为0.12%，0.17%和0.37%。第一跖骨截骨术（33626例患者）的DVT、肺栓塞和死亡率分别为0.01%、0.02%和0.04%，后足融合术（7033例患者）的发生率分别为0.03%、0.11%和0.11%。在1633例全踝关节置换患者中，肺栓塞发生率为0.06%，无DVT记录，无死亡。统计分析只能确定骨折手术后静脉血栓栓塞事件的危险因素，年龄增加和多种合并症。足踝手术后静脉血栓栓塞非常罕见，但这部分骨折患者的风险较高。然而，没有证据表明血栓预防可以降低这种风险，这些国家数据表明，大多数患者不需要预防。
Diagnostic and operative codes are routinely collected for every patient admitted to hospital in the English NHS. Data on post-operative complications following foot and ankle surgery have not previously been available in large numbers. Data on symptomatic venous thromboembolism events and mortality within 90 days were extracted for patients undergoing fixation of an ankle fracture, first metatarsal osteotomy, hindfoot fusions and total ankle replacement over a period of 42 months. For ankle fracture surgery (45 949 patients), the rates of deep-vein thrombosis (DVT), pulmonary embolism and mortality were 0.12%, 0.17% and 0.37%, respectively. For first metatarsal osteotomy (33 626 patients), DVT, pulmonary embolism and mortality rates were 0.01%, 0.02% and 0.04%, and for hindfoot fusions (7033 patients) the rates were 0.03%, 0.11% and 0.11%, respectively. The rate of pulmonary embolism in 1633 total ankle replacement patients was 0.06%, and there were no recorded DVTs and no deaths. Statistical analysis could only identify risk factors for venous thromboembolic events of increasing age and multiple comorbidities following fracture surgery.Venous thromboembolism following foot and ankle surgery is extremely rare, but this subset of fracture patients is at a higher risk. However, there is no evidence that thromboprophylaxis reduces this risk, and these national data suggest that prophylaxis is not required in most of these patients.