Eur J Orthop Surg Traumatol. 2026 Oct 25;36(1):422. doi: 10.1007/s00590-026-04998-2.
ABSTRACT
PURPOSE: This study evaluated the national inpatient incidence, patient characteristics, and independent predictors of VTE following primary THA.
METHODS: A retrospective cohort study was performed using the National Inpatient Sample from 2016 to 2022. Adult patients undergoing primary THA were identified using ICD-10 procedure codes. The primary outcome was in-hospital VTE, defined as deep vein thrombosis or pulmonary embolism during the index admission. Survey-weighted analyses were used to generate national estimates, compare baseline characteristics, and identify independent predictors of VTE using multivariable logistic regression. Statistical significance was set at P < 0.05.
RESULTS: Among 855,645 weighted inpatient primary THA admissions, 1660 patients developed in-hospital VTE, corresponding to an incidence of 0.19%. Patients with VTE were older (P < 0.001) and more frequently covered by Medicare (P < 0.001), treated at large hospitals (P = 0.009), and treated at urban teaching hospitals (P = 0.013). They also had a greater prevalence of comorbidities, including autoimmune disease, coagulopathy, congestive heart failure, deficiency anemia, peripheral vascular disease, pulmonary circulation disorders, and moderate renal failure (all P < 0.001), as well as chronic pulmonary disease (P = 0.001) and obesity (P = 0.003). On adjusted analysis, the strongest predictors of VTE were paralysis (OR 9.79, P < 0.001), lymphoma (OR 4.35, P = 0.001), other neurologic disorders (OR 4.30, P < 0.001), and pulmonary circulation disorders (OR 3.50, P < 0.001). Additional independent predictors included peripheral vascular disease (OR 2.19, P < 0.001), autoimmune disease (OR 2.01, P < 0.001), congestive heart failure (OR 1.83, P = 0.022), coagulopathy (OR 1.80, P = 0.035), deficiency anemia (OR 1.65, P = 0.002), hypothyroidism (OR 1.45, P = 0.007), and obesity (OR 1.35, P = 0.018).
CONCLUSION: In-hospital VTE following primary THA was uncommon but concentrated among medically complex patients. Improved risk stratification may guide perioperative counseling, surveillance, and individualized thromboprophylaxis for higher-risk patients.
PMID:42927525 | DOI:10.1007/s00590-026-04998-2