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Systematic review and meta-analysis on the rate of postoperative venous thromboembolism in orthopaedic surgery in Asian patients without thromboprophylaxis

  1. B. Kanchanabat1,*,
  2. W. Stapanavatr1,
  3. S. Meknavin2,
  4. C. Soorapanth2,
  5. C. Sumanasrethakul3,
  6. P. Kanchanasuttirak1

Article first published online: 14 JUN 2011

DOI: 10.1002/bjs.7589

Issue

British Journal of Surgery

British Journal of Surgery

Volume 98, Issue 10, pages 1356–1364, October 2011

Additional Information

How to Cite

Kanchanabat, B., Stapanavatr, W., Meknavin, S., Soorapanth, C., Sumanasrethakul, C. and Kanchanasuttirak, P. (2011), Systematic review and meta-analysis on the rate of postoperative venous thromboembolism in orthopaedic surgery in Asian patients without thromboprophylaxis. British Journal of Surgery, 98: 1356–1364. doi: 10.1002/bjs.7589

Author Information

  1. 1

    Vascular Unit, Department of Surgery, Faculty of Medicine, Vajira Hospital, University of Bangkok Metropolitan, Bangkok, Thailand

  2. 2

    Department of Orthopaedics, Faculty of Medicine, Vajira Hospital, University of Bangkok Metropolitan, Bangkok, Thailand

  3. 3

    Department of Community Medicine, Faculty of Medicine, Vajira Hospital, University of Bangkok Metropolitan, Bangkok, Thailand

*Department of Surgery, Faculty of Medicine, Vajira Hospital, 681 Samsain Road, Dusit, Bangkok, Thailand 10300

Publication History

  1. Issue published online: 2 SEP 2011
  2. Article first published online: 14 JUN 2011
  3. Manuscript Accepted: 6 APR 2011

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Less than in the West

Abstract

Background:

Postoperative venous thromboembolism (VTE) is a common life-threatening complication after surgery. This review analysed the rate and mortality of VTE after orthopaedic surgery in Asia.

Methods:

Inclusion criteria were: prospective study; deep vein thrombosis (DVT) diagnosed by venography or ultrasonography; hip fracture surgery (HFS), total hip arthroplasty (THA) or total knee arthroplasty (TKA); and no thromboprophylaxis. The pooled proportion was back-calculated by Freeman–Tukey variant transformation, using a random-effects model.

Results:

Twenty-two studies (total population 2454) published from1979 to 2009 were included. Using venography, the pooled rates of all-site, proximal, distal and isolated distal DVT were 31·7, 8·9, 22·5 and 18·8 per cent respectively. With duplex ultrasonography, the respective rates were 9·4, 5·9, 5·9 and 5·8 per cent. After THA or HFS, using venography, the pooled rates of all-site and proximal DVT were 25·8 and 9·6 per cent; with ultrasonography, the respective rates were 10·8 and 7·2 per cent. In TKA groups, using venography, the pooled rates of all-site and proximal DVT were 42·5 and 8·7 per cent; with ultrasonography, the respective rates were 9·5 and 5·2 per cent. The overall pooled rates of symptomatic DVT and symptomatic pulmonary embolism (PE) were 4·5 and 0·6 per cent. No patient died from PE (pooled rate 0·2 per cent).

Conclusion:

None of these Asian patients undergoing orthopaedic surgery died from VTE. Pooled rates of proximal and symptomatic DVT were lower than in Western reports. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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