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. 2010 Jan;25(1):28-34.
doi: 10.3346/jkms.2010.25.1.28. Epub 2009 Dec 26.

Venous thromboembolism in Korean patients undergoing major orthopedic surgery: a prospective observational study using computed tomographic (CT) pulmonary angiography and indirect CT venography

Seung-Ick Cha  1 , Shin-Yeop Lee, Chang-Ho Kim, Jae-Yong Park, Tae-Hoon Jung, Jae-Hyuck Yi, Jongmin Lee, Seung Huh, Hyun-Joo Lee, Shin-Yoon Kim
Affiliations

Venous thromboembolism in Korean patients undergoing major orthopedic surgery: a prospective observational study using computed tomographic (CT) pulmonary angiography and indirect CT venography

Seung-Ick Cha et al. J Korean Med Sci. 2010 Jan.

Abstract

In patients undergoing major orthopedic surgery, data of deep venous thrombosis (DVT) and pulmonary embolism (PE) are lacking as studied by computed tomographic (CT) pulmonary angiography and indirect CT venography (CTPA-CTV). A prospective observational study was performed for 363 Korean patients undergoing major orthopedic surgery to determine the incidence of venous thromboembolism (VTE), especially proximal DVT and PE. The incidence of VTE was 16.3% (n=59). Of them, 8 patients (2.2%) were symptomatic. The rate of VTE was the highest in patients who underwent total knee replacement (40.4%), followed by hip fracture surgery (16.4%), and total hip replacement (8.7%; P<0.001). The incidence of PE was 6.6% (n=24). Of them, 4 patients (1.1%) were symptomatic. Forty-one patients (11.3%) were in the proximal DVT or PE group. Based on multivariate analysis, total knee replacement and age > or =65 yr were significant risk factors for proximal DVT or PE in patients undergoing major orthopedic surgery (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.1-5.1; P=0.025; and OR, 2.1; 95% CI, 1.0-4.4; P=0.046, respectively). Taken together, the overall incidence of PE was 6.6% and rate of symptomatic PE rate was 1.1%. Knee joint replacement and age > or =65 yr were significant risk factors for proximal DVT or PE.

Keywords: Computed Tomography; Orthopedics; Pulmonary Embolism; Venous Thromboembolism.

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Figures

Fig. 1
Fig. 1
On CT scan, a pulmonary embolus is visualized as a sharply delineated filling defect (arrow) in posterobasal segmental artery of right lower lobe with intact marginal blood flow in at least two consecutive image sections.
Fig. 2
Fig. 2
On CT scan, a deep venous thrombus is demonstrated in right superficial femoral vein as an intraluminal filling defect (arrow) surrounded by a high-attenuating ring of enhanced blood on at least two consecutive transverse images.
See this image and copyright information in PMC

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