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Author
(year) | Surgery type and population | PE incidence
n/N (%) | Postsurgical time course of PE | Comments |
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| Hope [22] (2007) | General, orthopedic, and other surgical procedures; 1999 to 2004 at a North Carolina medical center | 115/111,773 (0.9%) | <40 years of age, mean 2.6 days; 40 to 60 years, mean 11.2 days; >60 years, mean 6.7 days (p = 0.02) | The significantly longer interval to PE diagnosis in patients 40 to 60 years of age possibly due to delays in diagnosis, patient ambulation, and/or asymptomatic PE |
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| Arcelus [23] (2008) | Major orthopedic surgery, cancer surgery, and other procedures; through 2005 in the RIETE registry of patients with symptomatic acute VTE | 13,599 registry patients, 1602 postoperative, 787 with PE | 19% of PE diagnosed during first 7 days, 48% during first 15 days, 77% during first 30 days | Clinically overt PE appeared significantly earlier than proximal DVT (20 ± 15 days vs 24 ± 16 days, p <0.0001) |
|
| Sebastian [24] (2016) | Thoracolumbar surgery; 2005 to 2012 in a national database | 202/43,777 (0.5%) | Mean 9.4 ± 7.3 days | For patients undergoing corpectomy, the incidence of PE was 1.7%, mean time to diagnosis 12.4 ± 8.1 days |
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| Jordan [25] (2017) | Nephrectomy; 2006 to 2012 in a national database | 65/13,208 (0.5%) | Median 6 days (IQR 3–13); 63.1% of PE occurred prior to discharge | Median length of stay was 8 days for patients who developed PE (IQR 5–11) |
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| Thomas [26] (2018) | Lung cancer resection; 2005 to 2015 in a national database | 116/14,308 (0.8%) | Median 11 days (IQR 5–17); 67 (58%) of PE occurred after discharge | Prolonged duration of operation and extended length of stay (both p <0.01) were associated with increased risk for postdischarge VTE |
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| Phillips [27] (2003) | Elective total hip replacement (THR); July 1995 through June 1996 in analysis of Medicare claims data | Primary THR, 0.9% of 58,521; revision THR, 0.8% of 12,956 | Approximately 0.3% to 0.4% incidence of PE within the first week after THR, and about 0.7% to 0.8% by the sixth week | 26% of PE that developed within 6 months after primary THR occurred during acute inpatient stay, as did 38% of the PE in the revision THR patients |
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| Dahl [28] (2003) | Total hip replacement (THR), knee replacement (TKR), or nailed hip fracture (NHF); 1989 through 1998 in a Scandinavian hospital administering LMWH to all patients | Overall 50/3954 (1.3%); THR, 19/1661 (1.1%); TKR, 3/386 (0.8%); NHF, 28/1907 (1.5%) | Overall mean 27 days (range 1–173); THR mean 35 days (range 5–94); TKR mean 9 days (range 2–17); NHF mean 24 days (range 1–173) | Overall annual PE incidence ranged from 0.4% to 3.4%. PE incidence remained high for at least 1–3 months following major hip surgery, less following TKR. |
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| Bjornara [29] (2006) | Emergency hip fracture surgery or elective total hip replacement (THR) or total knee replacement (TKR); 1989 to 2001 at a Norwegian hospital | Overall, 1.1% of 5607; hip fracture, 32/2420 (1.3%); THR, 28/2512 (1.1%); TKR, 4/675 (0.6%) | Hip fracture, median 17 days (range 1–173); THR, median 34 days (range 3–150); TKR, median 12 days (range 2–150) | The cumulative risk of VTE lasted up to 3 months after hip surgery and for 1 month after TKR; 70% of postsurgery VTE were diagnosed after discharge |
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| SooHoo [30] (2006) | Total knee arthroplasty (TKA); 1991 through 2001 in California linked hospital discharge database | During initial hospitalization, 1.79% of 222,684 | PE rate 0.30% during first 30-day period, then declined to 0.06% for second 30-day period; the rate remained in range of 0.03% to 0.05% through the first postoperative year | PE rate stabilized within 30 days after surgery, and proportion of cases was increased by <3% at 60 days; extending follow-up to 90 days had small effect on the proportion of first-year PE cases |
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| Parvizi [31] (2015) | Total joint arthroplasty (TJA), patients receiving postprocedure warfarin; 2000 to 2010 at a university hospital in Philadelphia | 283/26,415 (1.07%), within 90 days | Median 2 days (range 1–87 days); 81% within first 3 days, 89% with first week, 94% within 2 weeks | The later PE after revision arthroplasty and in patients without atrial fibrillation possibly due to comorbidity-related delays in postoperative mobility/mobilization |
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| Kim [32] (2016) | Femur fracture in adult patients who underwent CT for PE within 72 hours after admission; January 2010 to December 2014 at a Korean medical center | 28/453 (2.2%) | PE detected in 16 (57.1%) of the 28 patients in the first 24 hours after injury, and in 25 (89.3%) in the first 48 hours | PE in femur fracture patients occurred in the immediate period following injury at a relatively higher incidence than commonly appreciated for other types of trauma. However, the outcome of PE in these cases was not fatal. |
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