Clinical InvestigationSurgeryThrombotic and bleeding complications after orthopedic surgery
Section snippets
Study design
We performed a retrospective cohort analysis of 3,294 consecutive subjects at a tertiary care academic medical center between November 1, 2008, and December 31, 2009. Patients >21 years of age who underwent hip, knee, or spine surgery were eligible. Two hundred twelve subjects <21 years of age were excluded leaving 3,082 subjects in this cohort. This study was approved by the institutional review board with an informed consent waiver.
Data sources
Data for this study were obtained from the hospital
Overall population
A total of 3,082 subjects who underwent orthopedic surgery of the spine (38%), knee (33%), and hip (30%) were included. Baseline characteristics are described in Table I. The mean age of the cohort was 60.8 ± 13.3 years, 59% were female, and 65% were white. A history of CAD was present in 327 subjects (11%). Forty-nine percent of subjects had a history of hypertension; 15%, diabetes; 3%, kidney disease; 2%, cancer; and 1%, peripheral vascular disease.
Adverse perioperative events are recorded in
Discussion
There have been few studies on thrombotic and bleeding complications after orthopedic surgery. This lack of information complicates the preoperative evaluation and makes it difficult to assess the thrombotic and bleeding risks of surgery. Furthermore, differences in both the study population and the definitions used for thrombotic and bleeding complications limit the comparison between studies. Our study showed an overall incidence of myocardial necrosis and major bleeding of 5.8% and 5.4%,
Disclosures
There are no conflicts of interest for any of the submitting authors.
Acknowledgements
Dr Berger was partially funded by an American Heart Association Fellow to Faculty Award (0775074N) and a Doris Duke Clinical Scientist Award (2010055).
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Hartzell V. Schaff, MD served as guest editor for this article.