Impact of postoperative venous thromboembolism on Medicare recipients undergoing total hip replacement or total knee replacement surgery

2010 ◽  
Vol 67 (17) ◽  
pp. 1438-1445 ◽  
Author(s):  
Onur Baser ◽  
Dylan Supina ◽  
Nishan Sengupta ◽  
Li Wang ◽  
Louis Kwong
Keyword(s):  
Venous Thromboembolism ◽  
Total Knee Replacement ◽  
Total Hip Replacement ◽  
Knee Replacement ◽  
Hip Replacement ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee

scholarly journals Increased Incidence of Total Knee Replacement Surgery in Patients With Psoriasis: A Secondary Cohort Analysis of a Nationwide, Population-Based Health Claims Database

2021 ◽  
Vol 8 ◽  
Author(s):  
Ming-Chi Lu ◽  
Kuo-Sheng Fan ◽  
Chia-Wen Hsu ◽  
Malcolm Koo ◽  
Ning-Sheng Lai
Keyword(s):  
Total Knee Replacement ◽  
Total Hip Replacement ◽  
Knee Replacement ◽  
Hip Replacement ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee

Patients with rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis, and systemic lupus erythematosus, have increased risk of receiving total knee replacement surgery or total hip replacement surgery. We speculated that psoriasis could also attack the joints of the knees and hips, leading to an increased risk of receiving total knee replacement surgery or total hip replacement surgery. The aim of this study was to investigate the risk of total knee replacement or total hip replacement surgery in patients with psoriasis using a nationwide, population-based health claims database in Taiwan. Using the Taiwan's National Health Insurance Research Database, we identified 10,819 patients with psoriasis between 2000 and 2012. A comparison cohort consisting of five patients without psoriasis for each patient with psoriasis was assembled, based on frequency matching for sex, 10-year age interval, and index year. Both groups were followed until a diagnosis of the study outcomes (total knee replacement or total hip replacement surgery) or the end of the follow-up period. Incidence rate ratios (IRRs) for the outcome variables were calculated using multiple Poisson regression models. Female patients with psoriasis exhibited a significantly higher incidence of receiving total knee replacement surgery [adjusted IRR = 1.44, p = 0.014)]. Analyses stratified by age groups showed that the risk of receiving total knee replacement surgery was significantly higher older (adjusted IRR = 1.31, p = 0.047) patients with psoriasis. There were no significant differences in the risk of receiving total hip replacement surgery in patients with psoriasis compared with controls, either with or without stratification by sex or age groups. In conclusion, patients with psoriasis were associated with an increased risk of receiving total knee. Clinicians should be vigilant in assessing the presence of arthritis in these patients, and initiate strategies to delay or prevent the need for joint replacement.

Pharmacoeconomic Analysis of Bemiparin and Enoxaparin as Prophylaxis for Venous Thromboembolism in Total Knee Replacement Surgery

2004 ◽  
Vol 22 (13) ◽  
pp. 885-894 ◽  
Author(s):  
Jes??s Honorato ◽  
Antonio G??mez-Outes ◽  
Antonio Navarro-Quilis ◽  
Javier Mart??nez-Gonz??lez ◽  
Eduardo Rocha ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Pharmacoeconomic Analysis ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee

scholarly journals Venous thromboembolism after total knee replacement or total hip replacement: what can be learnt from root-cause analysis?

2016 ◽  
Vol 98 (8) ◽  
pp. 538-542 ◽  
Author(s):  
S Benjamin ◽  
D Warwick
Keyword(s):  
Venous Thromboembolism ◽  
Total Knee Replacement ◽  
Total Hip Replacement ◽  
Knee Replacement ◽  
Hip Replacement ◽  
Cause Analysis ◽  
Total Hip ◽  
Root Cause ◽  
Baseline Effect ◽  
Total Knee

INTRODUCTION Because of the high risk of venous thromboembolism (VTE) in total hip replacement (THR) and total knee replacement (TKR), guidelines are used widely to enhance effective (yet safe) prophylaxis. If patients develop VTEs despite use of such guidelines, then the reasons are that the guidelines were: (i) followed but the VTE occurred anyway; (ii) not implemented appropriately. All VTEs are assessed routinely by root-cause analysis (RCA). METHODS The records and subsequent RCA reports for each patient who experienced clinically significant VTE after THR or TKR were reviewed. We established adherence to the guidelines (deemed to be ‘unavoidable’ with scope to improve the guidelines) and non-adherence (deemed to be ‘avoidable’ with scope to improve implementation). RESULTS Of 2,214 patients undergoing THR (n=1,330) or TKR (n=884), 25 (1.13%) experienced VTE. Four THR patients experienced VTE (2 of which were avoidable) and 21 TKR patients experienced VTE (5 of which were avoidable). There were significantly more VTEs in TKR patients than THR patients (p<0.0001). CONCLUSIONS A proportion of patients will experience VTE even if guidelines are followed (a baseline effect). Administration of chemical prophylaxis earlier might reduce this baseline effect further. This approach should be taken cautiously with due respect for the alternative risk of bleeding. Improvement in hospital routine may reduce the risk of VTE yet further.

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