J Korean Med Sci.  2016 Jan;31(1):80-88. 10.3346/jkms.2016.31.1.80.

Venous Thromboembolism Following Hip and Knee Replacement Arthroplasty in Korea: A Nationwide Study Based on Claims Registry

• Lee S
• Hwang JI
• Kim Y
• Yoon PW
• Ahn J
• Yoo JJ

• KMID: 2359996
• DOI: http://doi.org/10.3346/jkms.2016.31.1.80

Abstract

The aim of this study was to examine the incidence and trends of clinically relevant venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee replacement arthroplasty (HKRA) in Korea. Between January 1 and December 31, 2010, 22,127 hip replacement arthroplasty (HRA) patients and 52,882 knee replacement arthroplasty (KRA) patients were enrolled in the analysis using the administrative claims database of the Health Insurance Review and Assessment Service (HIRA). All available parameters including procedure history and clinically relevant VTE during the 90 days after HKRA were identified based on diagnostic and electronic data interchange (EDI) codes. The overall incidence of VTE, DVT, and PE during the 90 days was 3.9% (n=853), 2.7% (n=597), and 1.5% (n=327) after HRA, while the incidence was 3.8% (n=1,990), 3.2% (n=1,699), and 0.7% (n=355) after KRA. The incidence of VTE after HKRA was significantly higher in patients who had previous VTE history (odds ratio [OR], 10.8 after HRA, OR, 8.5 after KRA), chronic heart failure (2.1, 1.3), arrhythmia (1.8, 1.7), and atrial fibrillation (3.4, 2.1) than in patients who did not. The VTE incidence in patients with chemoprophylaxis was higher than that in patients without chemoprophylaxis. The incidence of VTEs revealed in this retrospective review was not low compared with the results of the studies targeting other Asian or Caucasian populations. It may warrant routine prevention including employment of chemoprophylaxis. However, the limitation of the reviewed data mandates large scale prospective investigation to affirm this observation.

Keyword

Venous Thromboembolism; Replacement Arthroplasty; Hip; Knee; Chemoprophylaxis; Korea

MeSH Terms

Adult
Aged
Aged, 80 and over
*Arthroplasty, Replacement, Hip
*Arthroplasty, Replacement, Knee
Databases, Factual
Female
Humans
Incidence
Male
Middle Aged
National Health Programs
Odds Ratio
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Venous Thromboembolism/*diagnosis/epidemiology

Figure

• 

  Fig. 1 Selection process and flowchart of study population. A flowchart shows the selection process of study population. A total of 22,127 patients who underwent hip replacement arthroplasty (HRA) and 52,882 patients who underwent knee replacement arthroplasty (KRA) at 882 hospitals nationwide were finally enrolled in the analysis between January 1 and December 31, 2010. Multiple hospitalizations were defined as one episode of hospitalizaton if the interval between the two successive hospitalizations was less than 2 days. Index procedure: the first replacement arthroplasty during the study period. Index date: the first date of hospitalization during which the index replacement arthroplasty was performed.

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