Wakabayashi et al identified risk factors for the presence of silent deep vein thrombosis in a patient prior to total hip arthroplasty. This can help to identify a patient who may be at increased risk for postoperative deep vein thromobosis. The authors are from Mie University in Japan.
Patient selection: prior to total hip arthroplasty
Prevalence of silent deep vein thrombosis in study population: 12%
Predictors of silent deep vein thrombosis:
(1) increased age (mean 67.5 +/- 9.5, versus 61.7 +/- 11.8; use >= 65 years in implementation)
(2) rheumatoid arthritis
(3) history of major surgery (any surgical procedure involving anesthesia or respiratory assistance)
A patient who is having a revision arthroplasty would be considered to have a history of major surgery.
The authors recommended screening the patient for silent deep vein thrombosis if the patient is at increased risk. This can be done with Doppler ultrasound.
Additional factors to consider:
(1) history of deep vein thrombosis
(2) active cancer without history of major surgery)
(3) hypercoagulable state
