Open AccessPredictors of Vein Thrombosis at Lower Limb Joints Arthroplasty in Oncologic Patients
Author(s) -
R. V Garyaev,
I. A Rychkov
Publication year - 2015
Publication title -
vestnik travmatologii i ortopedii imeni n.n. priorova
Language(s) - English
Resource type - Journals
eISSN - 2658-6738
pISSN - 0869-8678
DOI - 10.17816/vto201522231-35
Subject(s) - medicine , thrombosis , odds ratio , deep vein , surgery , perioperative , confidence interval , risk factor , body mass index , arthroplasty , anesthesia
Purpose of the study was to detect the factors that stipulated risk of vein thrombosis at arthroplasty of lower limb joints in oncologic patients. Retrospective data on 374 patients after hip and knee arthroplasty aa well as after total femur replacement were studied. The following risk factors were studied: age, gender, weight, height, body mass index, preoperative hemoglobin level, tumor morphology, presence of pathologic fracture, use of tranexamic acid, tourniquet application, type of regional anesthesia, intraoperative blood loss, duration of surgical intervention. Statistical analysis was performed using the method of multifactorial logistic regression. Independent risk factor for perioperative vein thrombosis was the age of patient (likelihood ratio χ2=26,6; р=0,000) In patients of 40 years and older the rate of thrombosis was higher as compared to younger ones: 24.4% (31/127) versus 6.1% (15/247); p =0.000; odds ratio 5; 95% confidence interval 2.6 - 9.7. Preoperative risk of vein thrombosis increased not only with patient’s age but in presence of pathologic fracture as well (likelihood ratio χ2 = 29,8; р=0,000) Other studied factors did not increase the rate of thrombosis. In presence of pathologic fracture the possibility of early anticoagulant therapy should be considered. Both prolonged epidural and peripheral nerve blockades can be used at such surgical interventions without risk of vein thrombosis rate increase.