Epidemiology of post-operative venous thromboembolismin asian countries

Alain Leizorovicz; Alexander G.G. Turpie; Alexander T. Cohen; Kuldip Singh Dhillon; Pantep Angchaisuksiri; Ching-Jen Wang

doi:10.1007/s00547-004-1010-1

International Journal of Angiology, Table of Contents

Int J Angiol 2004; 13(3): 101-108
DOI: 10.1007/s00547-004-1010-1

Original Articles

Epidemiology of post-operative venous thromboembolismin asian countries

Alain Leizorovicz¹ , Alexander G.G. Turpie² , Alexander T. Cohen³ , Kuldip Singh Dhillon⁴ , Pantep Angchaisuksiri⁵ , Ching-Jen Wang⁵

¹Service de Pharmacologie Clinique, EA 643, University of Lyon, Lyons, France
²Department of Medicine HHSC-General Division, Hamilton, Ontario, Canada
³Academic Department of Surgery, Guy's, King', Thomas' School of Medicine, London, U.K.
⁴Selangor Medical Centre, Selangor, Malaysia
⁵Division of Hematology, Ramathibodi Hospital, Bangkok, Thailand

Presented in part at the XVIII Congress of The International Society on Thrombosis and Haemostasis, Paris, France (July 6-12, 2001)*SMART: Surgical Multinational Asian Registry in Thrombosis

Abstract

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Abstract

Background In Asia, the prevalence of post-operative venous thromboembolism (VTE) is traditionally thought to be low and the routine use of thromboprophylaxis remains controversial.

Methods We performed an exhaustive literature search for published studies on VTE in Asia. Predefined data were extracted from individual studies: country involved, number of patients, type of patient population, type, duration and dose regimens of treatments, if any, method used to detect deep-vein thrombosis (DVT) and pulmonary embolism (PE), and duration of follow-up. The main endpoints were the incidences of systematically detected DVT, and symptomatic DVT or PE. Overall adjusted percentages and 95% confidence intervals (CI) were calculated.

Results In clinical studies in patients not receiving thromboprophylaxis, the adjusted incidence of total DVT was 13% (95% CI: 10% to 16%) in general surgery, 16% (95% CI: 13% to 20%) after total hip replacement, 50% (95% CI: 44% to 55%) after total knee replacement and 18% (95% CI: 12% to 24%) in hip fracture surgery. The adjusted incidence of PE was 1% (95% CI: 0% to 2%) in general surgery and 1.4% (95% CI: 1% to 3%) after total hip replacement. In autopsy studies, the incidence of fatal PE ranged from 0.2% to 6.0%, increasing consistently over a period of 30 years in Japan and Hong Kong.

Conclusions Post-operative VTE is frequent in Asian general and orthopedic surgery patients and the incidence of autopsy-proven fatal PE is increasing over time. The use of routine prophylaxis in Asian patients undergoing high-risk surgical procedures should be considered.

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