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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 92 - 92
1 Dec 2013
Jové N Markel D Samaan S Lincoln D
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Introduction:

A pulmonary embolus (PE) occurs frequently in medical patients and acutely in post surgical total joint patients. While the two groups seem vastly different, there has never been an analysis of the location, number of emboli a patient has and size of the emboli in post-operative total joint arthroplasty patients compared to general medical patients. Studies have looked at the size of PEs relative to symptomatic patients; recent data have suggested the timeline of PE development is usually within the first few days after total knee arthroplasty (TKA) or total hip arthroplasty (THA).

Methods:

We conducted a retrospective chart review at Providence Hospital from 2006 to 2011 of all THA and TKA patients who had a post-operative PE diagnosis and looked at their medical comorbidities, sex, age, procedure, post-operative day of PE, and size/location of PE using a novel pulmonary mapping tree database based on location of the PE on spiral computed tomography (CT). The same data, except for post-operative day, was collected for the medical population with a PE diagnosis. Size was defined based on level of blockage with small emboli occurring at different points within a lobe, medium being at the level of lobe, and large being either a saddle embolus or at the right or left pulmonary artery. Inclusion criteria for orthopaedic patients included THA or TKA performed prior to PE, PE within 1 month of surgery and CT confirming diagnosis of a PE. Medical patients meeting criteria had to have an admitting diagnosis of PE with CT confirmation of the PE. Exclusion criteria included V/Q scan alone to diagnose the PE.