Nationwide Study on the Risk of Unprovoked Venous Thromboembolism in Non-traumatic Osteonecrosis of Femoral Head

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2018 Mar 16

PMID 29541810

Citations 7

Authors

Pei-Hsun Sung

Hsin-Ju Chiang

Yao-Hsu Yang

John Y Chiang

Chi-Jen Chen

Hon-Kan Yip

Mel S Lee

Affiliations

Soon will be listed here.

Abstract

Purpose: Endothelial dysfunction is a risk factor for osteonecrosis of femoral head (ONFH) and venous thromboembolism (VTE) [defined as deep venous thrombosis (DVT) or pulmonary embolism (PE)]. However, the risk of unprovoked VTE in non-traumatic ONFH patients remains unclear.

Methods: We investigated the relationship between ONFH and VTE using Taiwan National Health Insurance Research Database (NHIRD). Between 1997 and 2010, a total of 1514 non-traumatic ONFH patients were identified from 1,000,000 general populations after excluding initially concomitant diagnoses of DVT and PE, and subjects undergoing lower limb surgery within one year since enrollment. The comparison group (n = 15,140) without ONFH was set up by matching study cohort with age, gender, income and urbanization in a 1:10 ratio. Subjects diagnosed with VTE within one year after surgery were also excluded.

Results: The patients with non-traumatic ONFH had significantly higher frequency of unprovoked VTE, including DVT, than general population (1.19 vs. 0.5%, p < 0.0007), whereas the frequency of PE was similar between these two groups (p = 0.4922). The cumulative incidence of VTE and DVT was also remarkably higher in the ONFH than non-ONFH group (all p < 0.001). After adjusting for age, gender, medications and comorbidities with multivariate analysis, the ONFH patients had a 2.3-fold increase in risk of DVT compared with non-ONFH counterparts (95% CI 1.28 to 4.13, p = 0.0053). Apart from ONFH, age > 65 years and hypertension were also identified as risk factors for DVT occurrence.

Conclusions: The incidence and risk of unprovoked VTE were significantly increased in the non-traumatic ONFH population.

Citing Articles

Pulmonary embolism and deep venous thrombosis in China.

Hu S J Geriatr Cardiol. 2024; 21(8):775-778.

PMID: 39308502 PMC: 11411264. DOI: 10.26599/1671-5411.2024.08.007.

Risk factors of preoperative deep vein thrombosis in patients with non-traumatic osteonecrosis of the femoral head.

Wu D, Wang T, Li C, Cheng X, Yang Z, Zhu Y BMC Musculoskelet Disord. 2024; 25(1):602.

PMID: 39080582 PMC: 11288110. DOI: 10.1186/s12891-024-07736-z.

Association of Nitric Oxide Synthase Polymorphism and Coagulopathy in Patients with Osteonecrosis of the Femoral Head.

Wu C, Lin R, Sung P, Kuo F, Yip H, Lee M J Clin Med. 2022; 11(17).

PMID: 36078892 PMC: 9457043. DOI: 10.3390/jcm11174963.

lncRNA FGD5-AS1 Regulates Bone Marrow Stem Cell Proliferation and Apoptosis by Affecting miR-296-5p/STAT3 Axis in Steroid-Induced Osteonecrosis of the Femoral Head.

Wu Y, Fang L, Gao Y, Zhao Z, Zhou L, Zhang G J Healthc Eng. 2022; 2022:9364467.

PMID: 35190765 PMC: 8858055. DOI: 10.1155/2022/9364467.

Risk of Venous Thromboembolic Events in Patients with Osteonecrosis of the Femoral Head Undergoing Primary Hip Arthroplasty.

Sung P, Yang Y, Chiang H, Chiang J, Yip H, Lee M J Clin Med. 2019; 8(12).

PMID: 31817684 PMC: 6947200. DOI: 10.3390/jcm8122158.

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