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Surgery
Research
Pulmonary embolism and mortality following total ankle replacement: a data linkage study using the NJR data set
  1. Razi Zaidi1,
  2. Alexander MacGregor2,
  3. Suzie Cro3,
  4. Andy Goldberg1
  1. 1Institute of Orthopaedics & Musculoskeletal Science, Royal National Orthopaedic Hospital NHS Trust, London, UK
  2. 2Norwich Medical School, University of East Anglia, Norwich, UK
  3. 3Clinical Trials Unit at UCL, Medical Research Council (MRC), London, UK
  1. Correspondence to Razi Zaidi; razizaidi{at}doctors.net.uk

Abstract

Objective To determine the mortality rate following total ankle replacement (TAR) and incidence of 90 day pulmonary embolism (PE) along with the associated risk factors.

Design Data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. Linkage was performed in a deterministic fashion. HES episodes 90 days after the index procedure were analysed for PE. Mortality data were obtained pertaining to all the index procedures from the NJR for analysis.

Participants All primary and revision ankle replacement patients captured on the NJR between February 2008 and February 2013.

Results The 90-day mortality following TAR was 0.13% (95% CI 0.03 to 0.52) and 1-year mortality was 0.72% (95% CI 0.40 to 1.30); no deaths were as a result of PE. The incidence of PE within 90 days following primary TAR was 0.51% (95% CI 0.23 to 1.13). There was only one PE following revision surgery. Patients with an Royal College of Surgeons Charlson score greater than zero were at 13 times greater risk of PE (p=0.003).

Conclusions There is low incidence of PE following TAR, but multiple comorbidities are a leading risk factor for its occurrence.

  • ankle replacement
  • data linkage
  • registry

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-011947

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