Risk Factors for Deep Vein Thrombosis or Pulmonary Embolus Following Anterior Cruciate Ligament Reconstruction.

Autor:	Bokshan SL; Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island, USA., DeFroda SF; Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island, USA., Panarello NM; Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, Massachusetts, USA., Owens BD; Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island, USA.; Department of Sports Medicine, Brown University, Alpert School of Medicine, Providence, Rhode Island, USA.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2018 Jun 21; Vol. 6 (6), pp. 2325967118781328. Date of Electronic Publication: 2018 Jun 21 (Print Publication: 2018).
DOI:	10.1177/2325967118781328
Abstrakt:	Background: Nearly 350,000 Americans develop a deep venous thromboembolism (DVT) or pulmonary embolism (PE) annually, and nearly 100,000 Americans die from these events. To date, little research has investigated patient-specific risk factors that increase the rate of DVT/PE following anterior cruciate ligament reconstruction (ACLR). Purpose: To determine relevant patient risk factors for the development of DVT/PE following ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: All instances of ACLR from 2005 to 2014 within the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine which patient demographics and surgical factors were associated with DVT or PE following surgery. Results: Of the 9146 patients who underwent ACLR, 46 (0.5%) developed postoperative DVT, 8 (0.1%) developed PE, and 5 (0.05%) developed both. The following variables were associated with the development of DVT or PE on univariate analysis: increased age, a high tibial osteotomy (HTO) performed at the time of ACLR, microfracture performed, the presence of hypertension requiring medical therapy, and the presence of an active wound infection. Independent predictors of DVT or PE on multivariate analysis included HTO (odds ratio [OR], 22.7), the presence of an active wound infection (OR, 11.0), or hypertension requiring medication (OR, 2.2). Meniscal repair was not a risk factor for DVT or PE on univariate or multivariate analysis. Conclusion: In a review of 9146 patients undergoing ACLR, 46 (0.5%) developed DVT in the 30-day postoperative period. Increasing age over 30 years, concomitant HTO or microfracture, hypertension requiring medication, and presence of wound infection were all associated with an increased risk of DVT. The annual incidence of DVT/PE following ACLR reconstruction is low (<1%) and has not changed over time. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: S.L.B. received educational funding from Stryker. B.D.O. has grants/grants pending from the Orthopaedic Research and Education Foundation and is a paid consultant for Mitek, ConMed Linvatec, the Musculoskeletal Transplant Foundation, DePuy, and Sanofi-Aventis.
Databáze:	MEDLINE
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