Back to Search Start Over

Stress-induced hyperglycaemia and venous thromboembolism following total hip or total knee arthroplasty: analysis from the RECORD trials.

Stress-induced hyperglycaemia and venous thromboembolism following total hip or total knee arthroplasty: analysis from the RECORD trials.

Authors :
Cohn DM
Hermanides J
DeVries JH
Kamphuisen PW
Kuhls S
Homering M
Hoekstra JB
Lensing AW
Büller HR
Source :
Thrombosis and haemostasis [Thromb Haemost] 2012 Feb; Vol. 107 (2), pp. 225-31. Date of Electronic Publication: 2011 Dec 21.
Publication Year :
2012

Abstract

Stress-induced hyperglycaemia is common during orthopaedic surgery. In addition, hyperglycaemia activates coagulation. The aim of the study was to assess whether stress-induced hyperglycaemia is associated with symptomatic or asymptomatic venous thromboembolism (VTE) following orthopaedic surgery. We performed post-hoc analyses in the four RECORD studies (REgulation of Coagulation in major Orthopaedic surgery reducing the Risk of Deep venous thrombosis and pulmonary embolism). Separate analyses were performed for patients undergoing elective total hip or knee replacement. Outcome measures were symptomatic VTE and "total VTE" (defined as the composite of symptomatic VTE, asymptomatic DVT assessed by per protocol venography and all cause mortality). Glucose levels were measured pre-op and 6 hours post-op, categorised into quartiles, based on the distribution in the respective cohorts. The influence of glucose, adjusted for body mass index, age, gender and diabetes mellitus on VTE was assessed by logistic regression analyses. A total of 12,383 patients were eligible for assessment of symptomatic VTE, and 8,512 patients were eligible for assessment of total VTE. Increased glucose levels after total hip replacement were associated with total VTE; adjusted odds ratio (OR) highest versus lowest quartile 1.9 (95% confidence interval [CI] 1.3 to 3.0). Furthermore, increase in glucose levels during total hip replacement was associated with total VTE (OR highest versus lowest quartile 1.8 (95%CI 1.2 to 2.8). This was not observed in patients undergoing total knee replacement, probably due to differences in the applied surgical procedures.

Details

Language :
English
ISSN :
2567-689X
Volume :
107
Issue :
2
Database :
MEDLINE
Journal :
Thrombosis and haemostasis
Publication Type :
Academic Journal
Accession number :
22187097
Full Text :
https://doi.org/10.1160/TH11-07-0447