Incidence of Preoperative Deep Vein Thrombosis in High Probability Patients undergoing Elective Hip and Knee Replacement Surgery

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Siwadol Wongsak Chavarat Jarungvittayakon Kulapat Chulsomlee Kitchai Luksameearunothai Tanapong Panpikoon Paphon Sa-ngasoongsong Noratep Kulachote Thanaphot Channoom Viroj Kawinwonggowit

Abstract

Background: Patients undergoing hip and knee replacement possessed high risk for deep vein thrombosis (DVT), which might not had been diagnosed preoperatively, resulting in higher postoperative morbidity. However, no previous studies have been reported the incidence of preoperative DVT in this group of patients.


Objective: This study aimed to evaluate the incidence of preoperative DVT in these patients with high probability for DVT, and correlate their risk factors between those who had and had not preoperative DVT.


Methods: A prospective observational study in patients undergoing hip and knee replacement, within 6-month period, was conducted. Demographic data, Caprini score, and serum D-dimer level were collected. All patients with high probability (HP) for DVT, as D-dimer level > 500 mg/dL, were send for doppler ultrasonography (D-USG). Risk factors in patients with positive D-USG were then compared to those with negative D-USG.


Results: Of 120 patients, 25 patients (21%) were classified into HP group. The overall incidence of preoperative DVT in our study was 12% (n = 3). There was no significant difference in baseline characteristic data and Caprini score between patients with positive and negative D-USG (P > 0.05).


Conclusion: Preoperative DVT in patients undergoing hip and knee replacement with high probability for DVT was not uncommon, as 12%. We recommended preoperative screening with D-dimer test in all patients and using D-USG as routine screening in patients with high probability for DVT.


 

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Wongsak, S., Jarungvittayakon, C., Chulsomlee, K., Luksameearunothai, K., Panpikoon, T., Sa-ngasoongsong, P., Kulachote, N., Channoom, T., & Kawinwonggowit, V. (2017). Incidence of Preoperative Deep Vein Thrombosis in High Probability Patients undergoing Elective Hip and Knee Replacement Surgery. Ramathibodi Medical Journal, 40(2), 1-7. Retrieved from https://www.tci-thaijo.org/index.php/ramajournal/article/view/85086
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