Surgery at high altitude may be a risk factor for venous thromboembolism in patients
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Key takeaways:
- Knee arthroplasty performed at an elevation of 4,000 feet or higher may increase cardiovascular complication risks in patients.
- Results were compared with patients who underwent surgery at lower elevations.
Published results showed patients who undergo total knee arthroplasty at an altitude of 4,000 feet or higher may be at increased risk for postoperative venous thromboembolism compared with patients who undergo surgery at lower altitudes.
Kevin D. Plancher, MD, MPH, from Plancher Orthopaedics and Sports Medicine, and colleagues performed a retrospective review of the PearlDiver Mariner database to analyze the effect of altitude on 306,281 patients who underwent primary TKA between 2011 and 2022.
After matching, Plancher and colleagues compared outcomes between 57,135 patients who underwent surgery at an elevation of 4,000 feet or higher and 171,322 patients who underwent surgery at an elevation of 100 feet or lower.
According to the study, outcome measures included venous thromboembolism (VTE), deep vein thrombosis (DVT) and pulmonary embolism (PE) at 30-day and 90-day follow-ups.
Plancher and colleagues found patients in the high-altitude group were at significantly increased risk for VTE at 30 days (OR = 1.15; 95% CI, 1.02-1.3) and 90 days (OR = 1.2; 95% CI, 1.08-1.34), as well as DVT at 30 days (OR = 1.3; 95% CI, 1.1-1.54) and 90 days (OR = 1.36; 95% CI, 1.18-1.57), compared with the patients in the low-altitude group. They found no significant difference in incidence of PE between the high- and low-altitude groups at 30 days or 90 days.
“Surgeons may account for the high-altitude risk factor as they determine the most suitable postoperative prophylaxis method for patients who have multiple comorbidities,” Plancher and colleagues wrote in the study.
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