Background: Sparse informations are available about venous thrombo-embolic (VTE) complications after different types of shoulder surgery. Aim: The primary end-point of the study was to determine the incidence of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) within 90 days of follow-up in patients undergoing shoulder surgery. Risk factors for VTE and thromboprophylaxis practices were also studied. Methods: RECOS is a prospective multicenter registry of consecutive patients undergoing shoulder surgery recruited in nine hospitals in Italy. Patients were followed-up at 7, 30 and 90 days for major clinical outcomes. Cumulative rates of VTE were estimated according to the Kaplan-Meier method; a Cox regression model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for some variables that were identified as potential risk factors for VTE. Results: From June 2009 to June 2011 1366 evaluable patients (males 54.4%; mean age 55.65  15.3 years) were enrolled in the registry. The shoulder surgical procedures were the following: arthroscopy (72%), arthrotomy (19.1%) total replacement (8.9%). After 90 days, the incidence rate (95% CI) of symptomatic DVT and PE was 0.7% (95CI% 0.2–11.2). Mean age of patient with VTE complications was significantly different from patients who did not displayed complications (55.6  0.42 vs. 25.7  0.2, P = 0.024). Duration of surgery > 60 min (HR: 10.99; 95CI% 1.26–95.89; P = 0.030) was found as independent risk factor for VTE. Pharmacological thromboprophylaxis was prescribed in 33.5% (n = 457) of the patients; in 95.8% of them the recommended duration of prophylaxis was > 10 days. Conclusions: The risk of symptomatic VTE in patients undergoing shoulder surgery is not negligible. This risk and the potential need for thromboprophylaxis should be taken into account by orthopaedic surgeons.

Venous thromboembolism in patients undergoing shoulder surgery: findings from the Recos registry

MURENA, LUIGI;
2013

Abstract

Background: Sparse informations are available about venous thrombo-embolic (VTE) complications after different types of shoulder surgery. Aim: The primary end-point of the study was to determine the incidence of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) within 90 days of follow-up in patients undergoing shoulder surgery. Risk factors for VTE and thromboprophylaxis practices were also studied. Methods: RECOS is a prospective multicenter registry of consecutive patients undergoing shoulder surgery recruited in nine hospitals in Italy. Patients were followed-up at 7, 30 and 90 days for major clinical outcomes. Cumulative rates of VTE were estimated according to the Kaplan-Meier method; a Cox regression model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for some variables that were identified as potential risk factors for VTE. Results: From June 2009 to June 2011 1366 evaluable patients (males 54.4%; mean age 55.65  15.3 years) were enrolled in the registry. The shoulder surgical procedures were the following: arthroscopy (72%), arthrotomy (19.1%) total replacement (8.9%). After 90 days, the incidence rate (95% CI) of symptomatic DVT and PE was 0.7% (95CI% 0.2–11.2). Mean age of patient with VTE complications was significantly different from patients who did not displayed complications (55.6  0.42 vs. 25.7  0.2, P = 0.024). Duration of surgery > 60 min (HR: 10.99; 95CI% 1.26–95.89; P = 0.030) was found as independent risk factor for VTE. Pharmacological thromboprophylaxis was prescribed in 33.5% (n = 457) of the patients; in 95.8% of them the recommended duration of prophylaxis was > 10 days. Conclusions: The risk of symptomatic VTE in patients undergoing shoulder surgery is not negligible. This risk and the potential need for thromboprophylaxis should be taken into account by orthopaedic surgeons.
http://onlinelibrary.wiley.com/doi/10.1111/jth.2013.11.issue-s2/issuetoc
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11368/2833143
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