Risk factors and prevalence of DVT after total hip replacement: A systematic review and meta-analysis

Objective: To systematically evaluate the risk factors for deep vein thrombosis (DVT) in patients after hip replacement. Methods: A computer search of PubMed, EMbase, The Cochrane Library, China Biology Medicine (CBM), China National Knowledge Internet (CNKI) and WanFang Data databases was conducted to collect case-control studies, cohort studies and cross-sectional studies on risk factors for DVT in hip replacement patients. January 2020. Meta-analysis was carried out using Stata 16.0 software after 2 researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. Results: A total of 27 studies were included, including 82,872 subjects with 16 risk factors, and the results of the meta-analysis showed that women [OR=3.06 (1.36, 6.88), p=0.0001], age [OR=2.04, 95% CI (1.73, 2.42), p<0.0001], body mass index (BMI) [OR=0.0001], and men [OR=0.0001] were at risk of bias. 3.95, 95% CI (2.69, 5.78), p=0.007], hypertension [OR=2.52, 95% CI (1.42, 4.46), p<0.0001], hyperlipidemia [OR=2.47, 95% CI (1.44, 4.24), p<0.0001]. Combined cardio-vascular underlying diseases [OR=2.53, 95% CI (1.47, 4.37), p<0.0001], varicose veins or DVT [OR=4.21, 95%]. CI (3.24, 5.47), p=0.012], anaesthetic methods [OR=3.55, 95% CI (1.85, 6.82), p<0.0001], duration of operation [OR=2.33, 95% CI (1.35, 4.04), p<0.0001 0.0001], bone cement prosthesis [OR=2.79, 95% CI (2.37, 3.29), p<0.0001] are risk factors for DVT in hip replacement patients, and appropriate postoperative training reduces the risk of DVT in these patients [OR=0.40, 95% CI (0.32, 0.51)]. Conclusions: Current evidence of this study suggests that women, older age, high BMI, hypertension, hyperlipidemia, combined cardio-vascular underlying diseases, varicose veins or deep vein disease, general anesthesia, prolonged operation time and the use of bone cement prosthesis are risk factors for the development of DVT in hip replacement patients. Healthcare professionals should enhance the protection of high-risk patients with these risk factors in order to reduce the incidence of DVT after hip replacement and to improve the clinical outcome of patients.