Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2013.54.355
Metabolic syndrome increases risk for pulmonary embolism after hip and knee arthroplasty
Boris Mraovic
orcid.org/0000-0003-4019-4084
; Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Brian R. Hipszer
; Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Richard H. Epstein
; Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Javad Parvizi
; Rothman Institute of Orthopedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Edward C. Pequignot
; Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia PA, USA
Inna Chervoneva
; Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia PA, USA
Jeffery I. Joseph
; Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Sažetak
Aim To investigate whether patients with metabolic syndrome
(MetS) undergoing total hip or knee replacement
have an increased risk for pulmonary embolism (PE).
Methods We studied patients undergoing total hip or
total knee replacement from January 2001 to April 2006.
The diagnosis of PE was based on a positive finding with
a chest CT or a lung scan. Components of MetS were defined
as 1) BMI≥30 kg/m2, 2) non-fasting preadmission glucose
≥11.1 mmol/L or diagnosis of diabetes, 3) hypertension,
and 4) dyslipidemia. MetS was diagnosed if at least
three of these components were present.
Results Of 7282 patients, 107 (1.47%) were diagnosed
with PE. The incidence of PE in patients with 0, 1, 2, 3, and
4 MetS components was respectively 0.85% (16/1888; 95%
confidence interval [CI] 0.5%-1.4%), 1.24% (31/2500; 95%
CI 0.9%-1.8%), 1.76% (34/1936; 95% CI 1.2%-2.5%), 2.64%
(21/796; 95% CI 1.7%-4.1%), and 3.09% (5/162; 95% CI
1.1%-7.4%). The independent risk factors for PE were age
≥70, knee as opposite to hip replacement, bilateral knee
surgery, congestive heart failure, and MetS or the number
of MetS components. The odds of PE independently increased
1.6 times (95% CI 1.01-2.56; P = 0.043) for patients
with MetS and 1.23 times (95% CI 1.02-1.48; P = 0.028) per
each additional MetS component.
Conclusion Patients with MetS are at increased risk for PE
after total joint arthroplasty. The increasing number of MetS
components significantly increased the incidence of PE.
Ključne riječi
Hrčak ID:
108674
URI
Datum izdavanja:
15.8.2013.
Posjeta: 1.070 *