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Incidence, characteristics, and risk factors of venous thromboembolism in shoulder arthroplasty-a systematic review

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Author(s)
Sang-Soo NaDu-Han KimByung-Chan ChoiChul-Hyun Cho
Keimyung Author(s)
Kim, Du HanCho, Chul Hyun
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Int Orthop
Issued Date
2022
Volume
46
Issue
9
Keyword
ShoulderArthroplastyVenous thromboembolismDeep vein thrombosisPulmonary embolismSystematic review
Abstract
Purpose:
The purpose of this study was to investigate the incidence, characteristics, and risk factors for venous thromboembolism (VTE) in patients who underwent shoulder arthroplasty (SA) through systematic review.

Methods:
A search of studies was conducted using the databases for PubMed, EMBASE, Scopus, Ovid, MEDLINE, and Cochrane Library according to the guidelines for PRISMA (Preferred Reporting Items for Systematic Meta-Analyses). Quality assessment was performed using the Methodological Index for Nonrandomized Studies (MINORS).

Results:
Nine studies (12,566 shoulders) were finally eligible and the mean MINORS score was 13.2 (ranges, 9–18). The overall incidence of VTE was 0.81% (78/9681) including 0.54% (52/9681) for deep vein thrombosis (DVT) and 0.33% (42/12,566) for pulmonary embolism (PE). There were no significant differences in the incidences according to the type of arthroplasty. DVT was detected at an average of 18.8 days after index surgery, and PE was detected at an average of 12.7 days after index surgery. The risk factors for VTE included age older than 70 years, higher BMI, raised Charlson Comorbidity Index, history of DVT, asthma, cardiac arrhythmia, diabetes, lower haemoglobin level, use of general endotracheal anaesthesia without interscalene nerve block, traumatic indication, longer operative time, and revision SA. The mortality rate was 4.1% (2/49) for VTE and 8.3% (2/24) for PE.

Conclusion:
Despite the fact that the overall incidence of VTE following SA was as low as 0.81%, shoulder surgeons should consider the potential for this serious complication in high-risk patients. Further well-designed large-scale studies are necessary to clarify the consensus for VTE after SA including risk factors, treatment, and prophylaxis.
Keimyung Author(s)(Kor)
김두한
조철현
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1432-5195
Source
https://link.springer.com/article/10.1007/s00264-022-05496-w
DOI
10.1007/s00264-022-05496-w
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44382
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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