Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies
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-analysi...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-020-02097-4 |
| _version_ | 1798024822344646656 |
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| author | Yipei Yang Ziyue Li Haifeng Liang Jing Tian |
| author_facet | Yipei Yang Ziyue Li Haifeng Liang Jing Tian |
| author_sort | Yipei Yang |
| collection | DOAJ |
| description | 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 2 = 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. |
| first_indexed | 2024-04-11T18:09:03Z |
| format | Article |
| id | doaj.art-b3440ab22bb94a0192dbfa30e6ccef43 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T18:09:03Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-b3440ab22bb94a0192dbfa30e6ccef432022-12-22T04:10:13ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-11-0115111010.1186/s13018-020-02097-4Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studiesYipei Yang0Ziyue Li1Haifeng Liang2Jing Tian3Department of Orthopedic and Joint Surgery, Zhu Jiang Hospital, Southern Medical UniversityDepartment of Doppler Ultrasonic Department, Shen Zhen Hospital, Southern Medical UniversityDepartment of Orthopedic and Joint Surgery, Zhu Jiang Hospital, Southern Medical UniversityDepartment of Orthopedic and Joint Surgery, Zhu Jiang Hospital, Southern Medical UniversityAbstract 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 2 = 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.https://doi.org/10.1186/s13018-020-02097-4Metabolic syndromeTotal knee arthroplastyTotal hip arthroplastyVenous thromboembolismMeta-analysis |
| spellingShingle | Yipei Yang Ziyue Li Haifeng Liang Jing Tian Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies Journal of Orthopaedic Surgery and Research Metabolic syndrome Total knee arthroplasty Total hip arthroplasty Venous thromboembolism Meta-analysis |
| title | Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies |
| title_full | Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies |
| title_fullStr | Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies |
| title_full_unstemmed | Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies |
| title_short | Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies |
| title_sort | association between metabolic syndrome and venous thromboembolism after total joint arthroplasty a meta analysis of cohort studies |
| topic | Metabolic syndrome Total knee arthroplasty Total hip arthroplasty Venous thromboembolism Meta-analysis |
| url | https://doi.org/10.1186/s13018-020-02097-4 |
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