Risk factors for venous thromboembolism after primary total joint arthroplasty: An analysis of 7511 Taiwanese patients

Abstract

Background: The need for thromboprophylaxis in Asian patients after primary total joint arthroplasty (TJA) remains inconclusive. We aimed to identify the risk factors for venous thromboembolism (VTE) events following primary TJA in a Taiwanese population. Methods: From January 2010 through December 2019, we studied 7,511 patients receiving primary TJA from a single surgeon. We validated the incidence and risk factors for 30-day and 90-day symptomatic VTE events, including age, sex, body mass index (BMI), smoking, medical comorbidities, VTE history, presence of varicose veins, total knee arthroplasty (TKA) versus total hip arthroplasty (THA), unilateral versus bilateral procedure and receipt of VTE prophylaxis, transfusion, and length of stay. Results: The incidence of 30-day and 90-day symptomatic VTE events was 0.33% and 0.44%, respectively. Multivariate regression analysis showed that BMI ≥30 (aOR: 4.862. 95% CI: 1.776-13.313), bilateral TJA procedure (aOR: 2.665, 95% CI: 1.000-7.104) and presence of varicose veins (aOR: 9.946, 95% CI: 1.099-90.024) were associated with increased odds of 30-day symptomatic VTE events. Age≥77 years (aOR, 2.358; 95% CI: 1.034-5.381) and BMI≥30 (aOR: 2.832; 95% CI: 1.039-7.721) were associated with increased odds of 90-day symptomatic VTE events. Conclusion: Age≥77 years, BMI ≥30, bilateral TJA procedure or presence of varicose veins may require pharmacological thromboprophylaxis because such patients have a higher risk of VTE after primary TJA.