Prevalence of blood clotting after hip procedures

Venous thromboembolism after hip procedures is not abnormally  common in Saudi Arabia

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The risk of blood clots for people with hip fractures in Saudi Arabia has been assessed by KAIMRC researchers. The study establishes how common venous thromboembolism (VTE) is among these patients, an important step towards preventing this life-threatening complication.

VTE involves the formation of blood clots in the deep venous system. These clots can cause local pain, swelling, and skin changes and can travel to the lungs to cause potentially fatal pulmonary embolism (PE). VTE is common after orthopaedic surgery, particularly after hip and knee procedures, though the reasons for this are unclear.

Salem Althuwaykh from KAIMRC and his colleagues investigated the prevalence of VTE among patients in Saudi Arabia with fractures of the hip or the acetabulum, the socket of the hip joint. “No study in our country or the Gulf region has been published on the prevalence of VTE with acetabular and hip fracture,” explains Althuwaykh. “We wanted to find the prevalence to assess how good we are at preventing VTE compared with other countries.”

The researchers analysed the records of 995 people with hip or acetabular fractures at the level 1 trauma centre at the King Abdulaziz Medical City in Saudi Arabia between 2009 and 2015. Patients were grouped according to whether they developed deep vein thrombosis (DVT),  PE, both, or neither.

The prevalence of VTE among patients with acetabular fractures was 5% and the prevalence among those with hip fractures was 3%. Comparison with studies conducted in Europe, the USA and Southeast Asia indicated that the identified rate of VTE among patients with hip fractures was similar but the rate among patients with acetabular fracture was lower. “Our findings provide a baseline prevalence of VTE in acetabular and hip fracture in Saudi Arabia, and our prevalence is the same as in developed countries,” concludes Althuwaykh.

On the basis of previous work suggesting a link between blood haemoglobin concentration and the risk of VTE, Althuwaykh and colleagues investigated this relationship in their data. They found that haemoglobin concentrations at admission did not differ between patients who did and did not develop VTE, suggesting no effect of haemoglobin concentration in this context.

“Our next step is to find associations between VTE in these patients and other risk factors, such as comorbidities, BMI, length of surgical procedure and length of hospital stay,” explains Althuwaykh. “We aim to establish a score to measure the risk of VTE in order to reduce or prevent this complication.”

References

  1.  Althuwaykh, S.H., et al. Prevalence of venous thromboembolism in patients with acetabular or hip fractures and their association with hemoglobin concentration. Journal of Musculoskeletal Surgery and Research 4 (2020). | article

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