Association Between Metabolic Syndrome and Venous Thromboembolism After Total Joint Arthroplasty: a Meta-analysis of Cohort Studies

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2020 Dec 1

PMID 33256765

Citations 2

Authors

Yipei Yang

Ziyue Li

Haifeng Liang

Jing Tian

Affiliations

Soon will be listed here.

Abstract

Objective: Metabolic syndrome (MetS) has been associated with hypercoagulative status. However, previous studies evaluating the association between MetS and incidence of venous thromboembolism (VTE) after total joint arthroplasty (TJA) showed inconsistent results. We performed a meta-analysis to evaluate the influence of MetS on the risk of VTE following TJA.

Methods: Cohort studies were identified by the search of PubMed, Embase, and the Cochrane's Library databases. A random-effect model was used if considerable heterogeneity was detected; otherwise, a fixed-effect model was used. Subgroup analyses according to the category of VTE, definition of MetS, category of procedure, and follow-up durations were performed.

Results: Seven cohort studies with 1,341,457 patients that underwent TJA were included, with 118,060 MetS patients (8.8%) at baseline. With a follow-up duration up to 3 months after surgery, 9788 patients had VTE. Pooled results with a random-effect model showed that MetS was not associated with increased overall VTE after TJA (adjusted risk ratio [RR] = 1.24, 95% confidence interval [CI] 0.89 ~ 1.72, p = 0.20; I = 69%). The results were not significantly affected by the diagnostic criteria of MetS, category of the procedure, and follow-up durations. Subgroup analyses showed that MetS was not associated with an increased the risk of pulmonary embolism ([PE], RR 1.06, 95% CI 0.37 ~ 3.02, p = 0.91), but an increased risk of deep vein thrombosis (DVT) after TJA (RR 3.38, 95% CI 1.83 ~ 6.24, p < 0.001).

Conclusions: Current evidence from observational studies suggests MetS might be associated with an increased risk of DVT but not PE after TJA.

Citing Articles

Basic science research opportunities in thrombosis and hemostasis: Communication from the SSC of the ISTH.

Mutch N, Walters S, Gardiner E, McCarty O, De Meyer S, Schroeder V J Thromb Haemost. 2022; 20(6):1496-1506.

PMID: 35352482 PMC: 9325489. DOI: 10.1111/jth.15718.

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care.

Yu X, Wu Y, Ning R BMC Musculoskelet Disord. 2021; 22(1):547.

PMID: 34130675 PMC: 8207610. DOI: 10.1186/s12891-021-04417-z.

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