Post-discharge venous thromboembolism and bleeding in a large cohort of patients undergoing total hip or total knee arthroplasty

Michael H. Huo, Donna L. Spencer, Bijan J. Borah, Roger M. Mills, Ying Fan, Aaron Yarlas, Winslow Klaskala

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

• Objective: To examine the incidence of and risk factors for venous thromboembolism (VTE) and bleeding in a US population of total hip or total knee arthroplasty (THA/TKA) patients. • Design: Retrospective database study. • Setting: Health care claims records (2004-2009) from a large insurance plan linked to an inpatient database. • Participants: THA/TKA patients with no evidence of prior orthopaedic surgeries or prior VTE and no postdischarge orthopaedic surgeries. • Measurements: ICD-9-CM and CPT/HCPC codes were used to identify symptomatic VTE and bleeding events up to 90 days post-surgery. • Results: Of 9167 linked patients (3109 THA; 6058 TKA; median age 60 years; mean Charlson-Quan comorbidity score 0.5), 98% received thromboprophylaxis in hospital and 26% received it post-discharge. Mean overall duration of antithrombotic drug exposure was 10.7 days. 226 (2.5%) patients experienced VTE, and 324 (3.5%) had bleeding. Consistent covariates of post-discharge VTE and bleeding were inpatient VTE or bleeding events, respectively, and all-cause rehospitalization. Post-discharge thromboprophylaxis did not achieve statistical significance as a bleeding risk factor. • Conclusion: Patients who experience VTE or bleeding events during index hospitalization and those rehospitalized within 90 days have higher odds of postdischarge thromboembolic and bleeding outcomes, respectively. Post-discharge thromboprophylaxis for THA/TKA does not significantly increase the risk of post-discharge bleeding.

Original languageEnglish (US)
Pages (from-to)355-363
Number of pages9
JournalJournal of Clinical Outcomes Management
Volume19
Issue number8
StatePublished - Aug 1 2012

ASJC Scopus subject areas

  • Health Policy

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