Publication

UK Foot and Ankle Thromboembolism (UK-FATE)

Mangwani, Jitendra
; 
Houchen-Wolloff, Linzy
; 
Malhotra, Karen
; 
Booth, Sarah
; 
Smith, Aiden
; 
Teece, Lucy
; 
Mason, Lyndon W
; 
UK FATE Collaborative
; 
UK FATE Collaborative
; 
Shaikh, Rabia
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Affiliation
University Hospital of Leicester NHS Trust; British Orthopaedic foot and ankle society; Foot Print; The Dudley Group NHS Foundation Trust et al
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Publication date
2024-11-01
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2024
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Abstract
Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture. Secondary aims were to assess the variation in the provision of chemical prophylaxis and risk factors for VTE. This was a multicentre, prospective national collaborative audit with data collection over nine months for all patients undergoing foot and ankle surgery in an operating theatre or TA rupture treatment, within participating UK hospitals. The association between VTE and thromboprophylaxis was assessed with a univariable logistic regression model. A multivariable logistic regression model was used to identify key predictors for the risk of VTE. A total of 13,569 patients were included from 68 sites. Overall, 11,363 patients were available for analysis: 44.79% were elective (n = 5,090), 42.16% were trauma excluding TA ruptures (n = 4,791), 3.50% were acute diabetic procedures (n = 398), 2.44% were TA ruptures undergoing surgery (n = 277), and 7.10% were TA ruptures treated nonoperatively (n = 807). In total, 11 chemical anticoagulants were recorded, with the most common agent being low-molecular-weight heparin (n = 6,303; 56.79%). A total of 32.71% received no chemical prophylaxis. There were 99 cases of VTE (incidence 0.87% (95% CI 0.71 to 1.06)). VTE-related mortality was 0.03% (95% CI 0.005 to 0.080). Univariable analysis showed that increased age and American Society of Anesthesiologists (ASA) grade had higher odds of VTE, as did having previous cancer, stroke, or history of VTE. On multivariable analysis, the strongest predictors for VTE were the type of foot and ankle procedure and ASA grade. The 90-day incidence of symptomatic VTE and mortality related to VTE is low in foot and ankle surgery and TA management. There was notable variability in the chemical prophylaxis used. The significant risk factors associated with 90-day symptomatic VTE were TA rupture and high ASA grade.
Citation
Mangwani, J
Houchen-Wolloff L
Malhotra K
Booth S
Smith A
Teece L
Mason LW; UK FATE Collaborative; UK FATE Collaborative; Shaikh R
Alfred W
Okhifun I
Cinar E
Bua N
Vemulapalli K
Acharya A
Gadd R
Money-Taylor J
Kantharaju R
Bhosale A
Bahri S
Broadbent R
Drummond I
Jones N
Shah S
Ravindrarjah T
Yasen Z
Singh K
Al-Habs R
Jeyaseelan L
Habbiba A
Walker T
Dewhurst M
Glasgow N
Eze D
Carter G
Rajan P
Patil V
Amer O
Malik K
Pavanerathan P
Mallick A
Seferiadis I
Currall V
Sadasivan P
Kumar S
Sanjani SR
Ciaccio M
Ayyaswamy B
Prasad P
Anand M
Sunilraj D
Lane S
Prathap S
Kankate R
Aktselis I
Davda K
Vijapur A
Tayyem M
Chau J
Azhar MS
Sturdee S
Hussain H
Sonde S
Luqman MQ
Farooq R
Wells G
Shenolikar A
Simons M
Hodgson P
Thomas R
Stevens S
Elhassan Y
Adeniyi A
Aspinall W
Joseph V
Day M
Tong A
Joyner C
Alzaranky M
Elhassan O
Chhantyal K
Arora A
Abiddin Z
Kucharski R
Ahmad I
Zeb J
Ishaq U
Thomas J
Jain K
Deol R
Faroug R
Johal K
Mordecai S
Argyropouos M
Chawla A
Ibrahim M
Pereira M
Barr L
Julies E
Hill F
Kapoor S
Bailey J
Mukhopadhyay I
Rana S
Tarig H
Qualaghassi M
Seewoonarian S
Rose B
Crate G
Abbott S
Fenner C
Geleit R
Yousaf S
Akram N
Al-Hubeshy Z
Patel B
Hussein M
Clark C
Giddie J
Dega R
Dasari K
Nandhara G
Kumar P
Gupta P
Poole H
Zace P
Alvi F
Jacob J
Reddy R
Sateesh V
Gledhill A
Craven J
Cichero M
Yates B
Newton A
Grice J
Fawcett N
Fraig H
Hamad F
Marsland D
Elliot R
Ghani Y
Chandrashekhar S
Millan RK
Clark A
Rahman K
Sykes M
Little Z
Saleem J
Jolly L
Jain A
Qadri A
Rymaruk S
Kulkarni A
Garabadi M
Akhtar M
Hossain M
Yunus S
Saleem M
Fong J
Islam A
Nusir B
Chapman J
Holmes D
Mamoowala N
Almond K
Wright C
Caruana E
Watson T
Allison G
Pillai A
Madhi I
Alsalihy M
Elamin K
Yip CR
Tew L
Dahiya R
Goff T
Bagshaw O
Slade H
Andrzejowski P
Gomati A
Drake C
Hind J
Morgan R
Khalaf A
Ditta A
Ramasamy A
McIntyre J
Blacklock C
Middleton S
Clayton R
Hrycaiczuk A
Thornhill C
Jeyakumar G
Vaithilingam D
Potter K
Jamal/Pete Chan B
Mohamed M
Fraser D
Elhalawany A
Beastall J
Cousins G
Nunag P
Loveday D
Bawa A
Gilmore R
Schankat K
Walls A
Corin N
Robinson P
Hepple S
Harries W
Riddick A
Winson I
Marsh L
Bashir MA
Saini J
Atkinson H
Limaye R
Johnson-Lynn S
Sethi M
Flanagan G
Uddin A
Reilly I
Martin R
Pujol-Nichol A
Carroll N
Boucher A
Alward M
Myint Y
Butler K
Kendal A
Bugeja M
Mooteeram J
Saedi F
Koc T
Morcos Z
Robertson G
Holmes N
Tribe H
Pearkes T
Soliman A
Prasanna A
Teoh K
Kamat S
Bajracharya A
Reeves J
Ngwayi M
Imtiaz G
Blackmore N
Lau B
Naik A
Tung E
Murhekar S
Ray R
Lyle S
Makwana N
Kaisi KA
Al-Musabi M
Dean M
Hughes A
Shuttlewood K
Welck M
Patel S
Sykes A
Thibbaiah MM
Hadi H
Haldar A
Ardakani AG
Jani P
Kutuzov V
Gibbons J
Trussler D
Hawley E
Akhtar S
Rajgor HD
Budair B
Prem H
Mckenzie J
Thurston D
O'Sullivan M
Elmajee M
Pond E
Zahra W
Heaver C
Igbagiri K
Gaukroger A
Solan M
Peacock C
Fan KS
Barton T
Robinson D
Graham S
Zeolla J
Everett S
Iqbal M
Gourbault L
Singh S
Tang C
Tarhini M
Khan S
Balasubramanian S
Lever C
Bansod V
Iyengar K
Wadood A
McMillan L
Toh E
Masunda S
Federer S
Ahmad F
Lashin A
Kaddah A
Oladeji E
Dawe E
Nolan C
El-Bayouk K
Dhukaram V
Chapman A
Beddard L
Thomas A
Garg V
Taylor H
Kelsall N
Roslee C
Akram N
Lowdon H
Kamel-Sherif A
Jones A
Best A
Zabaglo M
Sayani J
Kyaw O
Khin C
Ali R
Shaik Y
Hossain N
Valente L
Ajis A
Guha A
Pereira M
Ayoub A
Paraoan V
Hali N
Baird C
Kugan R
Abdallatif A
Blomfield M
Jackson G
Craven J
Malhotra A
Toner A
Render L
Ashley C
Limb R
Smith R
Hughes L
Matthews H
Shiers-Gelalis F
Ting J
Place S
Budgen A
Stanley J
Jowett C. UK Foot and Ankle Thromboembolism (UK-FATE). Bone Joint J. 2024 Nov 1;106-B(11):1249-1256. doi: 10.1302/0301-620X.106B11.BJJ-2024-0128.R1
Type
Description
Handle
http://hdl.handle.net/20.500.14200/7057
Additional Links
DOI
10.1302/0301-620X.106B11.BJJ-2024-0128.R1
PMID
39481430
Journal
Publisher
Bone & Joint
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