Patient factors impact risk of venous thromboembolism after THA, TKA
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Key takeaways:
- Patient factors may have a greater impact on venous thromboembolism risk in those having total joint arthroplasty compared with thromboprophylactic agents.
- Thromboprophylaxis should be tailored to each patient.
According to published results, underlying patient factors may have a greater impact on risk of venous thromboembolism in patients undergoing total hip or knee arthroplasty compared with thromboprophylactic agents.
Researchers performed a retrospective cohort of data from 10,948 patients who underwent THA and 18,316 patients who underwent TKA to analyze 30-day incidences of post-discharge venous thromboembolism (VTE) and bleeding. Researchers also performed a propensity-matched analysis of patients who received a direct oral anticoagulant (DOAC) and patients who received aspirin
According to the study, patients were excluded if they received preoperative anticoagulation, received no postoperative pharmacological thromboprophylaxis or received multiple postoperative thromboprophylactic agents.
Among all patients, cumulative incidence of VTE was 1.19% and cumulative incidence of bleeding was 3.43% at 30 days postoperatively. Researchers found prior VTE history (odds ratio = 5.94), hereditary hypercoagulable state (OR = 2.64), TKA (OR = 1.65) and male sex (OR = 1.34) were factors associated with increased risk of VTE. Researchers found no significant differences in VTE risk between patients who received DOACs and aspirin; however, they noted postoperative bleeding was more common in patients who received DOACs.
“These results suggest that thromboprophylaxis strategies should be patient-centric and tailored to individual risk of thrombosis and bleeding,” the researchers wrote in the study.
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