Deep vein thrombosis in arthroscopic surgery and chemoprophylaxis recommendation in an Asian population
Research article published in Singapore medical journal (2016)
Abstract
INTRODUCTION: There are currently no guidelines supporting the use of routine chemoprophylaxis to prevent deep vein thrombosis (DVT) in arthroscopic surgery. Studies and meta-analysis show opposing views on its routine use in arthroscopy. This study aimed to examine the incidence of DVT in a prospective cohort of knee arthroscopy and knee arthroplasty patients, and to analyse the risk factors contributing to DVT. METHODS: All patients scheduled to undergo knee arthroscopy or arthroplasty over a two-year period were included. A standardised regimen of postoperative mechanical prophylaxis and rehabilitation was applied to all patients. Only patients who were postoperatively symptomatic were referred for ultrasonography. DVT incidence was calculated, and univariate and multivariate analyses of the risk factors were performed. RESULTS: The overall incidence of DVT was 0.5% among the 1,410 arthroscopy patients and 3.1% among the 802 arthroplasty patients. The incidence of proximal DVT among the arthroscopy and arthroplasty patients was 0.4% and 1.1%, respectively. Multivariate analysis showed that age was the only significant predictor of DVT incidence. Using the receiver operating characteristic method, the cut-off age for the arthroscopy and arthroplasty patients was 52 years, while that for the arthroscopy patients only was 40 years (increased risk of DVT: 5.46 and 6.44 times, respectively; negative predictive value: 99.7% and 99.8%, respectively). CONCLUSION: DVT incidence among Asian arthroplasty and arthroscopy patients remains low, even without chemoprophylaxis. Since age was found to be a significant risk factor for DVT, DVT prophylaxis can be considered for patients in high-risk age groups.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This prospective cohort tracked symptomatic deep vein thrombosis after knee arthroscopy and arthroplasty in an Asian population, reporting low overall DVT incidence (0.5% arthroscopy, 3.1% arthroplasty) and identifying age as the only significant predictor, leading the authors to suggest selective rather than routine chemoprophylaxis. For hirudotherapy the connection is contextual rather than direct: it helps frame the background thrombosis-risk and anticoagulation landscape in which leech therapy and leech-derived anticoagulants are sometimes discussed, but the study involves no leeches or leech-derived agents. The honest caveat is that this is a single-population cohort about surgical DVT epidemiology and prophylaxis decisions; it offers no data on hirudotherapy and should not be presented as supporting it, only as part of the broader venous-thromboembolism evidence backdrop.
Citation
Deep vein thrombosis in arthroscopic surgery and chemoprophylaxis recommendation in an Asian population.
Yeo KS et al. · Singapore medical journal, 2016
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