Venous Thromboembolism Following Total Knee Arthroplasty: Does Race Matter?

Jessell M Owens; Nicholas A Bedard; Spencer B Dowdle; Yubo Gao; John J Callaghan

doi:10.1016/j.arth.2018.01.045

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Venous Thromboembolism Following Total Knee Arthroplasty: Does Race Matter?

Journal article

Peer reviewed

Venous Thromboembolism Following Total Knee Arthroplasty: Does Race Matter?

Jessell M Owens, Nicholas A Bedard, Spencer B Dowdle, Yubo Gao and John J Callaghan

The Journal of arthroplasty, Vol.33(7S), pp.S239-S243

07/2018

DOI: 10.1016/j.arth.2018.01.045

PMID: 29500089

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Abstract

Venous thromboembolism (VTE) (deep venous thrombosis and pulmonary embolism) is a known complication following total knee arthroplasty (TKA). Recent literature has identified differences in VTE risk based on race with African Americans having higher risk of VTE. This study evaluated the impact of race on VTE following TKA using a large multicenter database. We queried the American College of Surgeons National Surgical Quality Improvement Program to identify patients who underwent primary TKA in 2010-2014. Patients were stratified based on race: Asian, Black/African American, White, and Other. Demographics were compared to determine the impact on 30-day postoperative complications. Multivariate logistic regression analysis was performed to control for confounding demographics and comorbidities between races. Primary outcomes included overall complications and VTE. In total, 96,230 patients were included. Univariate analysis demonstrated that Blacks had a significantly higher rate of any complication (5.5%), deep venous thrombosis (1.3%), and pulmonary embolism (1.1%) than other races (P = .007, P < .001, and P < .001, respectively). Overall mortality rate did not differ between races (P = .26). Multivariate regression analysis identified that Blacks were significantly more likely to have a VTE than Whites (odds ratio 1.7, 95% confidence interval 1.4-2.0). Overall complications were significantly higher for Blacks than Whites (odds ratio 1.1, 95% confidence interval 1.02-1.3). There were no differences in the rates of VTE or overall complications between Asians/Other races and Whites. Blacks have a significantly higher risk of VTE following primary TKA than other races. Future studies should investigate causes for this disparity.

Multivariate Analysis

United States - epidemiology

Postoperative Complications - etiology

Arthroplasty, Replacement, Knee - adverse effects

Comorbidity

Venous Thromboembolism - ethnology

Humans

Middle Aged

Risk Factors

European Continental Ancestry Group

Male

Venous Thrombosis - etiology

Venous Thromboembolism - etiology

Asian Continental Ancestry Group

Pulmonary Embolism - etiology

Postoperative Complications - ethnology

Female

Aged

African Continental Ancestry Group

Odds Ratio

Details

Title: Subtitle: Venous Thromboembolism Following Total Knee Arthroplasty: Does Race Matter?
Creators: Jessell M Owens - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Nicholas A Bedard - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Spencer B Dowdle - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Yubo Gao - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
John J Callaghan - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.33(7S), pp.S239-S243
Publisher: United States
DOI: 10.1016/j.arth.2018.01.045
PMID: 29500089
ISSN: 0883-5403
eISSN: 1532-8406
Language: English
Date published: 07/2018
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
Record Identifier: 9984040286002771

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