These authors performed a retrospective database review of symptomatic thromboembolic (VTE) events and mortality within 90 days of shoulder arthroplasty in a large (30-hospital) integrated healthcare system over a 5-year period, from January 2005 to December 2009. They compared the likelihood of these events and death in patients undergoing reverse shoulder arthroplasties (RSAs), total shoulder arthroplasties (TSAs), and hemiarthroplasties (HAs), and compared the likelihood of these events and death in patients who underwent elective shoulder arthroplasties with those who underwent shoulder arthroplasty in the setting of acute trauma.
In the 2574 eligible shoulder arthroplasties identified during the study period, VTE developed in 1.01% of patients (deep vein thrombosis 0.51% and pulmonary embolism 0.54%). VTE occurred more frequently in patients having surgery for traumatic indications than after elective surgery (1.71% versus 0.80%; p = 0.055). A higher likelihood of 90-day mortality was observed in trauma patients compared with elective (odds ratio = 7.4; 95% CI, 2.4-25.2).
These data are helpful in consideration of the use of pharmacologic VTE prophylaxis in the perioperative treatment of patients undergoing shoulder arthroplasty. One one hand, such prophylaxis may reduce the risk of thromboembolic complications, but on the other it may increase the risk of wound complications and hematomas.
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