TY - JOUR
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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U2 - 10.1016/j.thromres.2014.05.014
DO - 10.1016/j.thromres.2014.05.014
M3 - Article
C2 - 24916548
AN - SCOPUS:84905084601
VL - 134
SP - 273
EP - 277
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
IS - 2
ER -