Venous thromboembolism in patients undergoing shoulder surgery: Findings from the RECOS Registry

Davide Imberti, Nicola Ivaldo, Luigi Murena, Paolo Paladini, Alessandro Castagna, Giovanni Barillari, Enrico Guerra, Giuseppe Fama, Filippo Castoldi, Bruno Marelli, Matteo Giorgi Pierfranceschi, Giuseppe Camporese, Francesco Dentali, Giuseppe Porcellini

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Limited informations are available about venous thromboembolic (VTE) complications and thromboprophylaxis use after shoulder surgery. 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 after 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. Cumulative rates of VTE were estimated according to the Kaplan-Meier method; a Cox regression model was used to calculate adjusted hazard ratio (HR) and 95% confidence interval (CI) for some variables that were identified as risk factors for VTE. Results From June 2009 to June 2011 1366 patients (males 54.4%; mean age 55,65 ± 15.3 years) were enrolled. The surgical procedures were: arthroscopy (71.9%), hemiarthroplasty (17.2%) total replacement (8.9%), fixation for proximal humeral fracture (2%). After 90 days, the incidence of symptomatic VTE was 0.66% (95CI% 0.2-1.12). Mean age was significantly higher in patient with than in patients without VTE (67,1 +/3.49 years vs 55,6 +/- 0,42 years, respectively; p = 0.024). Duration of surgery > 60 minutes (HR:10.99; 95CI% 1.26-95.89; p = 0.030) was found as independent risk factor for VTE, while cancer, medical disease, venous insufficiency and previous VTE were not. Pharmacological thromboprophylaxis was prescribed in 33.5% (n = 457) of the patients, in 95.8% of whom for a duration > 10 days. Conclusions The risk of symptomatic VTE in patients undergoing shoulder surgery is low. The potential need for thromboprophylaxis should be based on a case by case evaluation.

Original languageEnglish
Pages (from-to)273-277
Number of pages5
JournalThrombosis Research
Volume134
Issue number2
DOIs
Publication statusPublished - 2014

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Venous Thromboembolism
Registries
Shoulder Fractures
Hemiarthroplasty
Venous Insufficiency
Arthroscopy
Incidence
Pulmonary Embolism
Proportional Hazards Models
Venous Thrombosis
Italy
Pharmacology
Confidence Intervals
Neoplasms

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

Venous thromboembolism in patients undergoing shoulder surgery : Findings from the RECOS Registry. / Imberti, Davide; Ivaldo, Nicola; Murena, Luigi; Paladini, Paolo; Castagna, Alessandro; Barillari, Giovanni; Guerra, Enrico; Fama, Giuseppe; Castoldi, Filippo; Marelli, Bruno; Pierfranceschi, Matteo Giorgi; Camporese, Giuseppe; Dentali, Francesco; Porcellini, Giuseppe.

In: Thrombosis Research, Vol. 134, No. 2, 2014, p. 273-277.

Research output: Contribution to journalArticle

Imberti, D, Ivaldo, N, Murena, L, Paladini, P, Castagna, A, Barillari, G, Guerra, E, Fama, G, Castoldi, F, Marelli, B, Pierfranceschi, MG, Camporese, G, Dentali, F & Porcellini, G 2014, 'Venous thromboembolism in patients undergoing shoulder surgery: Findings from the RECOS Registry', Thrombosis Research, vol. 134, no. 2, pp. 273-277. https://doi.org/10.1016/j.thromres.2014.05.014
Imberti, Davide ; Ivaldo, Nicola ; Murena, Luigi ; Paladini, Paolo ; Castagna, Alessandro ; Barillari, Giovanni ; Guerra, Enrico ; Fama, Giuseppe ; Castoldi, Filippo ; Marelli, Bruno ; Pierfranceschi, Matteo Giorgi ; Camporese, Giuseppe ; Dentali, Francesco ; Porcellini, Giuseppe. / Venous thromboembolism in patients undergoing shoulder surgery : Findings from the RECOS Registry. In: Thrombosis Research. 2014 ; Vol. 134, No. 2. pp. 273-277.
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abstract = "Background Limited informations are available about venous thromboembolic (VTE) complications and thromboprophylaxis use after shoulder surgery. 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 after 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. Cumulative rates of VTE were estimated according to the Kaplan-Meier method; a Cox regression model was used to calculate adjusted hazard ratio (HR) and 95{\%} confidence interval (CI) for some variables that were identified as risk factors for VTE. Results From June 2009 to June 2011 1366 patients (males 54.4{\%}; mean age 55,65 ± 15.3 years) were enrolled. The surgical procedures were: arthroscopy (71.9{\%}), hemiarthroplasty (17.2{\%}) total replacement (8.9{\%}), fixation for proximal humeral fracture (2{\%}). After 90 days, the incidence of symptomatic VTE was 0.66{\%} (95CI{\%} 0.2-1.12). Mean age was significantly higher in patient with than in patients without VTE (67,1 +/3.49 years vs 55,6 +/- 0,42 years, respectively; p = 0.024). Duration of surgery > 60 minutes (HR:10.99; 95CI{\%} 1.26-95.89; p = 0.030) was found as independent risk factor for VTE, while cancer, medical disease, venous insufficiency and previous VTE were not. Pharmacological thromboprophylaxis was prescribed in 33.5{\%} (n = 457) of the patients, in 95.8{\%} of whom for a duration > 10 days. Conclusions The risk of symptomatic VTE in patients undergoing shoulder surgery is low. The potential need for thromboprophylaxis should be based on a case by case evaluation.",
author = "Davide Imberti and Nicola Ivaldo and Luigi Murena and Paolo Paladini and Alessandro Castagna and Giovanni Barillari and Enrico Guerra and Giuseppe Fama and Filippo Castoldi and Bruno Marelli and Pierfranceschi, {Matteo Giorgi} and Giuseppe Camporese and Francesco Dentali and Giuseppe Porcellini",
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T1 - Venous thromboembolism in patients undergoing shoulder surgery

T2 - Findings from the RECOS Registry

AU - Imberti, Davide

AU - Ivaldo, Nicola

AU - Murena, Luigi

AU - Paladini, Paolo

AU - Castagna, Alessandro

AU - Barillari, Giovanni

AU - Guerra, Enrico

AU - Fama, Giuseppe

AU - Castoldi, Filippo

AU - Marelli, Bruno

AU - Pierfranceschi, Matteo Giorgi

AU - Camporese, Giuseppe

AU - Dentali, Francesco

AU - Porcellini, Giuseppe

PY - 2014

Y1 - 2014

N2 - Background Limited informations are available about venous thromboembolic (VTE) complications and thromboprophylaxis use after shoulder surgery. 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 after 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. Cumulative rates of VTE were estimated according to the Kaplan-Meier method; a Cox regression model was used to calculate adjusted hazard ratio (HR) and 95% confidence interval (CI) for some variables that were identified as risk factors for VTE. Results From June 2009 to June 2011 1366 patients (males 54.4%; mean age 55,65 ± 15.3 years) were enrolled. The surgical procedures were: arthroscopy (71.9%), hemiarthroplasty (17.2%) total replacement (8.9%), fixation for proximal humeral fracture (2%). After 90 days, the incidence of symptomatic VTE was 0.66% (95CI% 0.2-1.12). Mean age was significantly higher in patient with than in patients without VTE (67,1 +/3.49 years vs 55,6 +/- 0,42 years, respectively; p = 0.024). Duration of surgery > 60 minutes (HR:10.99; 95CI% 1.26-95.89; p = 0.030) was found as independent risk factor for VTE, while cancer, medical disease, venous insufficiency and previous VTE were not. Pharmacological thromboprophylaxis was prescribed in 33.5% (n = 457) of the patients, in 95.8% of whom for a duration > 10 days. Conclusions The risk of symptomatic VTE in patients undergoing shoulder surgery is low. The potential need for thromboprophylaxis should be based on a case by case evaluation.

AB - Background Limited informations are available about venous thromboembolic (VTE) complications and thromboprophylaxis use after shoulder surgery. 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 after 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. Cumulative rates of VTE were estimated according to the Kaplan-Meier method; a Cox regression model was used to calculate adjusted hazard ratio (HR) and 95% confidence interval (CI) for some variables that were identified as risk factors for VTE. Results From June 2009 to June 2011 1366 patients (males 54.4%; mean age 55,65 ± 15.3 years) were enrolled. The surgical procedures were: arthroscopy (71.9%), hemiarthroplasty (17.2%) total replacement (8.9%), fixation for proximal humeral fracture (2%). After 90 days, the incidence of symptomatic VTE was 0.66% (95CI% 0.2-1.12). Mean age was significantly higher in patient with than in patients without VTE (67,1 +/3.49 years vs 55,6 +/- 0,42 years, respectively; p = 0.024). Duration of surgery > 60 minutes (HR:10.99; 95CI% 1.26-95.89; p = 0.030) was found as independent risk factor for VTE, while cancer, medical disease, venous insufficiency and previous VTE were not. Pharmacological thromboprophylaxis was prescribed in 33.5% (n = 457) of the patients, in 95.8% of whom for a duration > 10 days. Conclusions The risk of symptomatic VTE in patients undergoing shoulder surgery is low. The potential need for thromboprophylaxis should be based on a case by case evaluation.

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