Abstract
• Objective: To examine the incidence of and risk factors for venous thromboembolism (VTE) and bleeding in a US population of total hip or total knee arthroplasty (THA/TKA) patients. • Design: Retrospective database study. • Setting: Health care claims records (2004-2009) from a large insurance plan linked to an inpatient database. • Participants: THA/TKA patients with no evidence of prior orthopaedic surgeries or prior VTE and no postdischarge orthopaedic surgeries. • Measurements: ICD-9-CM and CPT/HCPC codes were used to identify symptomatic VTE and bleeding events up to 90 days post-surgery. • Results: Of 9167 linked patients (3109 THA; 6058 TKA; median age 60 years; mean Charlson-Quan comorbidity score 0.5), 98% received thromboprophylaxis in hospital and 26% received it post-discharge. Mean overall duration of antithrombotic drug exposure was 10.7 days. 226 (2.5%) patients experienced VTE, and 324 (3.5%) had bleeding. Consistent covariates of post-discharge VTE and bleeding were inpatient VTE or bleeding events, respectively, and all-cause rehospitalization. Post-discharge thromboprophylaxis did not achieve statistical significance as a bleeding risk factor. • Conclusion: Patients who experience VTE or bleeding events during index hospitalization and those rehospitalized within 90 days have higher odds of postdischarge thromboembolic and bleeding outcomes, respectively. Post-discharge thromboprophylaxis for THA/TKA does not significantly increase the risk of post-discharge bleeding.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 355-363 |
| Number of pages | 9 |
| Journal | Journal of Clinical Outcomes Management |
| Volume | 19 |
| Issue number | 8 |
| State | Published - Aug 2012 |
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ASJC Scopus subject areas
- Medicine(all)
- Health Policy
Cite this
Post-discharge venous thromboembolism and bleeding in a large cohort of patients undergoing total hip or total knee arthroplasty. / Huo, Michael H.; Spencer, Donna L.; Borah, Bijan J.; Mills, Roger M.; Fan, Ying; Yarlas, Aaron; Klaskala, Winslow.
In: Journal of Clinical Outcomes Management, Vol. 19, No. 8, 08.2012, p. 355-363.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Post-discharge venous thromboembolism and bleeding in a large cohort of patients undergoing total hip or total knee arthroplasty
AU - Huo, Michael H.
AU - Spencer, Donna L.
AU - Borah, Bijan J.
AU - Mills, Roger M.
AU - Fan, Ying
AU - Yarlas, Aaron
AU - Klaskala, Winslow
PY - 2012/8
Y1 - 2012/8
N2 - • Objective: To examine the incidence of and risk factors for venous thromboembolism (VTE) and bleeding in a US population of total hip or total knee arthroplasty (THA/TKA) patients. • Design: Retrospective database study. • Setting: Health care claims records (2004-2009) from a large insurance plan linked to an inpatient database. • Participants: THA/TKA patients with no evidence of prior orthopaedic surgeries or prior VTE and no postdischarge orthopaedic surgeries. • Measurements: ICD-9-CM and CPT/HCPC codes were used to identify symptomatic VTE and bleeding events up to 90 days post-surgery. • Results: Of 9167 linked patients (3109 THA; 6058 TKA; median age 60 years; mean Charlson-Quan comorbidity score 0.5), 98% received thromboprophylaxis in hospital and 26% received it post-discharge. Mean overall duration of antithrombotic drug exposure was 10.7 days. 226 (2.5%) patients experienced VTE, and 324 (3.5%) had bleeding. Consistent covariates of post-discharge VTE and bleeding were inpatient VTE or bleeding events, respectively, and all-cause rehospitalization. Post-discharge thromboprophylaxis did not achieve statistical significance as a bleeding risk factor. • Conclusion: Patients who experience VTE or bleeding events during index hospitalization and those rehospitalized within 90 days have higher odds of postdischarge thromboembolic and bleeding outcomes, respectively. Post-discharge thromboprophylaxis for THA/TKA does not significantly increase the risk of post-discharge bleeding.
AB - • Objective: To examine the incidence of and risk factors for venous thromboembolism (VTE) and bleeding in a US population of total hip or total knee arthroplasty (THA/TKA) patients. • Design: Retrospective database study. • Setting: Health care claims records (2004-2009) from a large insurance plan linked to an inpatient database. • Participants: THA/TKA patients with no evidence of prior orthopaedic surgeries or prior VTE and no postdischarge orthopaedic surgeries. • Measurements: ICD-9-CM and CPT/HCPC codes were used to identify symptomatic VTE and bleeding events up to 90 days post-surgery. • Results: Of 9167 linked patients (3109 THA; 6058 TKA; median age 60 years; mean Charlson-Quan comorbidity score 0.5), 98% received thromboprophylaxis in hospital and 26% received it post-discharge. Mean overall duration of antithrombotic drug exposure was 10.7 days. 226 (2.5%) patients experienced VTE, and 324 (3.5%) had bleeding. Consistent covariates of post-discharge VTE and bleeding were inpatient VTE or bleeding events, respectively, and all-cause rehospitalization. Post-discharge thromboprophylaxis did not achieve statistical significance as a bleeding risk factor. • Conclusion: Patients who experience VTE or bleeding events during index hospitalization and those rehospitalized within 90 days have higher odds of postdischarge thromboembolic and bleeding outcomes, respectively. Post-discharge thromboprophylaxis for THA/TKA does not significantly increase the risk of post-discharge bleeding.
UR - http://www.scopus.com/inward/record.url?scp=84865063263&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865063263&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:84865063263
VL - 19
SP - 355
EP - 363
JO - Journal of Clinical Outcomes Management
JF - Journal of Clinical Outcomes Management
SN - 1079-6533
IS - 8
ER -