Incidence and Risk Factors for Venous Thromboembolism Following Hip Arthroscopy: A Population-Based Study
Incidence and Risk Factors for Venous Thromboembolism Following Hip Arthroscopy: A Population-Based Study
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DOI：
10.1016/j.arthro.2019.03.054
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发表时间：
2019-08-01
影响因子：
4.7
通讯作者：
Westermann, Robert W.
中科院分区：
文献类型：
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作者：
Khazi, Zain M.;An, Qiang;Westermann, Robert W.
目的：在考虑几个患者人口统计学因素的同时，使用一个大型国家数据库来确定髋关节镜术后症状性静脉血栓栓塞症(VTE)的发生率。方法：使用相关的现行程序术语和国际疾病分类第九和第十修订版代码，在Humana管理索赔数据库中识别2007-2017年间接受HA治疗的20岁患者。记录基本人口学资料，包括年龄、性别、肥胖(体重指数=30 kg/m(2))、口服避孕药使用、吸烟史、糖尿病和慢性阻塞性肺疾病(CLD)。在术后30天和90天观察深静脉血栓形成、肺栓塞和静脉血栓栓塞症的发生率。多因素Logistic回归分析确定了HA术后VTE的独立危险因素，统计学意义设为P<；0.05。结果：在研究期间，总共有9,477名患者接受了HA手术，其中5,085名(53.7%)是女性。30天和90天的VTE总发生率分别为0.77%(n=73)和1.14%(n=108)。多因素分析显示年龄=45岁(优势比[OR]=1.82；95%可信区间[CI]，1.36-2.49；P=0.0001)、肥胖(OR=1.54；95%CI，1.27-1.86；P<；0.0001)、吸烟(OR=1.26；95%CI，1.04-1.53；P=.0177)、糖尿病(OR=1.59；95%CI，1.32-1.92；P<；和CLD(OR=-2.10；95%CI，1.63-2.68；P<；0.0001)是HA术后VTE发生率较高的独立危险因素。然而，性别和口服避孕药的使用都不是HA术后VTE的危险因素。结论：HA术后症状性VTE发生率较低。这项研究确定年龄=45岁、肥胖、吸烟、糖尿病和慢性阻塞性肺疾病是HA术后VTE的独立危险因素。
Purpose: To determine the incidence of symptomatic venous thromboembolism (VTE) after hip arthroscopy (HA) using a large national database while considering several patient demographic factors. Methods: Patients >= 20 years old who underwent HA between 2007 and 2017 were identified within the Humana administrative claims database using relevant Current Procedural Terminology and International Classification of Diseases Ninth and Tenth Revision codes. Basic demographics, including age, gender, obesity (body mass index >= 30 kg/m(2)), oral contraceptive use, smoking history, diabetes, and chronic obstructive pulmonary disease (CLD) were recorded. Postoperative incidence of deep vein thrombosis, pulmonary embolism, and VTE was identified at 30 and 90 days postoperatively. Multivariate logistic regression analysis was performed to identify independent risk factors for VTE after HA, with statistical significance set at P < .05. Results: Overall, 9,477 patients underwent HA procedures over the study period, of whom 5,085 (53.7%) were female. The overall incidence of VTE in all patients was 0.77% (n = 73) and 1.14% (n = 108) at 30 and 90 days, respectively. Multivariate analysis identified age >= 45 (odds ratio [OR] = 1.82; 95% confidence interval [CI], 1.36-2.49; P = .0001), obesity (OR = 1.54; 95% CI, 1.27-1.86; P < .0001), smoking (OR = 1.26; 95% CI, 1.04-1.53; P = .0177), diabetes (OR = 1.59; 95% CI, 1.32-1.92; P < .0001), and CLD (OR = -2.10; 95% CI, 1.63-2.68; P < .0001) as independent risk factors for higher incidence of VTE after HA. However, neither gender nor oral contraceptive use were risk factors for VTE after HA. Conclusions: For patients undergoing HA, the incidence of symptomatic postoperative VTE is low. This study identified age >= 45, obesity, tobacco use, diabetes, and CLD as independent risk factors for VTE after HA.