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Symptomatic venous thromboembolism and mortality in orthopaedic surgery – an observational study of 45 968 consecutive procedures

Overview of attention for article published in BMC Musculoskeletal Disorders, June 2013
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Title
Symptomatic venous thromboembolism and mortality in orthopaedic surgery – an observational study of 45 968 consecutive procedures
Published in
BMC Musculoskeletal Disorders, June 2013
DOI 10.1186/1471-2474-14-177
Pubmed ID
Authors

Lasse J Lapidus, Sari Ponzer, Hans Pettersson, Edin de Bri

Abstract

BACKGROUND: Little information exists on the presentation of symptomatic venous thromboembolism (VTE) in orthopaedic surgery when a defined protocol for thromboprophylaxis is used. The objective with this study was to establish the VTE rate and mortality rate in orthopaedic surgery. METHODS: We performed a prospective, single centre observational cohort study of 45 968 consecutive procedures in 36 388 patients over a 10 year period. Follow-up was successful in 99.3%. The primary study outcome was the incidence of symptomatic deep vein thrombosis (DVT), symptomatic pulmonary embolism (PE) and mortality at 6 weeks, specified for different surgical procedures. The secondary outcome was to describe the DVT distribution in proximal and distal veins and the proportion of VTEs diagnosed after hospital discharge. For validation purposes, a retrospective review of VTEs diagnosed 7--12 weeks postoperatively was also performed. RESULTS: In total, 514 VTEs were diagnosed (1.1%; 95% CI: 1.10-1.14), the majority (84%) after hospital discharge (432 out of 514).With thromboprophylaxis, high incidence of VTE was found after internal fixation (IF) of pelvic fracture (12%; 95% CI: 5--26), knee replacement surgery (3.7%; 95% CI: 2.8-5.0), after internal fixation (IF) of proximal tibia fracture (3.8%; 95% CI: 2.3-6.3) and after IF of ankle fracture (3.6%; 95% CI: 2.9-4.4). Without thromboprophylaxis, high incidence of VTE was found after Achilles tendon repair (7.2%; 95% CI: 5.5-9.4). In total 1094 patients deceased (2.4%; 95% confidence interval (CI): 2.33- 2.44) within 6 weeks of surgery. Highest mortality was seen after lower limb amputation (16.3%, CI: 13.8-19.1) and after hip hemiarthroplasty due to hip fracture (9.6%, CI; 7.6-12.1). CONCLUSION: The overall incidence of VTE is low after orthopaedic surgery but our study highlights surgical procedures after which the risk for VTE remains high and improved thromboprophylaxis is needed.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 129 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Tanzania, United Republic of 1 <1%
Unknown 127 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 23 18%
Student > Bachelor 13 10%
Other 10 8%
Student > Doctoral Student 10 8%
Researcher 9 7%
Other 34 26%
Unknown 30 23%
Readers by discipline Count As %
Medicine and Dentistry 69 53%
Nursing and Health Professions 6 5%
Unspecified 5 4%
Biochemistry, Genetics and Molecular Biology 2 2%
Engineering 2 2%
Other 7 5%
Unknown 38 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 June 2013.
All research outputs
#14,615,662
of 23,394,907 outputs
Outputs from BMC Musculoskeletal Disorders
#2,193
of 4,130 outputs
Outputs of similar age
#113,041
of 199,013 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#45
of 69 outputs
Altmetric has tracked 23,394,907 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,130 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.2. This one is in the 43rd percentile – i.e., 43% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 199,013 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 69 others from the same source and published within six weeks on either side of this one. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.