Preoperative incidence and risk factors of deep vein thrombosis in Japanese patients undergoing total hip arthroplasty

• Published in: European journal of orthopaedic surgery & traumatology Vol. 33; no. 7; pp. 2859 - 2864
• Main Authors: Kaneko, Taizo, Nakamura, Shinya, Hayakawa, Kentaro, Tokimura, Fumiaki, Miyazaki, Tsuyoshi
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.10.2023; Springer Nature B.V
• Subjects: Joint replacement surgery; Malnutrition; Medicine; Medicine & Public Health; Original Article; Risk factors; Surgical Orthopedics; Thromboembolism; Thrombosis; Traumatic Surgery; Deep vein thrombosis; Preoperative; Geriatric nutritional risk index; Malnutrition; Total hip arthroplasty
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-023-03508-y

Purpose Preoperative deep vein thrombosis (DVT) is a risk factor for postoperative venous thromboembolism (VTE), causing severe mortality. Early detection of preoperative DVT is essential to prevent postoperative VTE. However, little is known regarding preoperative DVT in patients undergoing major surgery. The present study aimed to determine the incidence and risk factors of preoperative DVT in patients admitted for total hip arthroplasty (THA). Methods From August 2017 to September 2022, 243 patients admitted for THA at our institution were enrolled in this study. Patients medical records and preoperative laboratory data were retrospectively collected. According to the results of lower-limb ultrasonography, patients were divided into either the non-DVT (n = 136) or DVT (n = 43) group. The incidence of DVT and independent risk factors for preoperative DVT were investigated using univariate and multivariate logistic regression analyses. Results The mean age was 74.0 ± 8.4 years. Preoperative DVT was diagnosed in 43 of the 243 (17.7%) patients. The risk of DVT was significantly high ( p  < 0.05) in patients with advanced age, increased D-dimer levels, and malnutrition status, as assessed by the Geriatric Nutritional Risk Index (GNRI). Multivariate analysis showed that advanced age, increased D-dimer level, and malnutrition status assessed by the GNRI were independent risk factors for preoperative DVT. Conclusion A high incidence of preoperative DVT was observed in patients undergoing THA. Advanced age, increased D-dimer levels, and malnutrition assessed by the GNRI increased the risk of preoperative DVT. Screening high-risk subgroups for preoperative DVT is necessary to prevent postoperative VTE.