Prevalence and Risk Factors for Symptomatic Thromboembolic Events after Shoulder Arthroplasty

Deep venous thrombosis and pulmonary embolism after shoulder arthroplasty are not well described. We sought to identify the frequency of deep venous thrombosis and pul- monary embolisms in patients after shoulder arthroplasties to compare these rates with the frequency of deep venous thrombosis and pulmonary embolisms among patients who had total hip and total knee arthroplasties, and to identify associated risk factors. The New York State Department of Health Statewide Planning and Research Cooperative Sys- tem database was used to identify hospital admissions of patients having shoulder, hip, or knee arthroplasties between 1985 and 2003 with or without an associated diagnostic code for deep venous thrombosis or pulmonary embolism. This resulted in a retrospective cohort of 328,301 procedures. The frequency of deep venous thrombosis was 5.0 per 1000 pro- cedures for shoulder arthroplasties compared with 15.7 for hip arthroplasties and 26.9 for knee arthroplasties. The frequency of pulmonary embolisms was 2.3 for shoulder arthroplasties, 4.2 for hip arthroplasties, and 4.4 for knee arthroplasties. Increasing age, trauma, and cancer were risk factors for thromboembolic events after shoulder arthroplasties. Al- though the absolute rates of thromboembolic complications were less in patients who had shoulder arthroplasties com- pared with those of patients who had lower extremity pro- cedures, a larger percentage of these complications were pul- monary embolisms. Perioperative antithrombotic prophy- laxis may be beneficial to reduce the frequency of deep venous thrombosis and pulmonary embolisms among pa- tients having shoulder arthroplasties, particularly in higher- risk groups.

Level of Evidence: Prognostic study, Level II (retrospective study). See the Guidelines for Authors for a complete de- scription of levels of evidence.

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