Table 3.

Comparisons of Studies Examining Effects of Comorbidities and Physical Function with Postoperative VTE

Studies Examining Effects of Comorbidities
Study	Population	Procedure	Comorbidity Data Source	Outcome Data Source	Significant findings*
Kapoor(current)	24,051 veterans aged 65+	THR, TKR	ICD-9-CM codes from inpatient and outpatient utilization in 2 years preop	Hospitalization and 90 days post- op in- or outpatient VA follow-up	COPD 1.24 (1.06–1.45)
Kapoor11	316,671 adults aged 65+	Primary THR, TKR	ICD-9-CM codes listed at time of discharge from index hospitalization	Initial hospitalization	CHF alone€ THR 3.08 (2.05–4.65) TKR 2.47 (1.95–3.14) COPD alone TKR 1.49 (1.31–1.70)
Kikura3	21,903 adults	Any elective surgery	Prospective preop evaluations	Hospitalization and 30 days post op	CAD 2.9 (1.8–4.8)
Jaffer4	269 female patients aged 50+ median age = 74	TKR	Retrospective manual chart review	Initial hospitalization and 45 days post op	CHF 6.55 (1.47–45.3)
Pedersen6	67,469 adults	Primary THR	ICD-8 and ICD-10 codes inpatient utilization in 15 years preop	Initial and subsequent hospitalizations	Cardiovascular diseases† 1.40(1.15–1.70) Other diseases‡ 1.45 (1.21–1.72)
Gangireddy7	118,258 adults mean age = 65	9 common surgeries including THR	Retrospective chart review	Hospitalization and 30 day post op	COPD 1.45 (1.23–1.70)
Schiff8	310 adults mean age =72	THR, TKR, HFS	Retrospective chart review	Initial + 1 year postop	CHF or recent MI¥ 1.12 (0.38–3.29)
Studies Examining Effects of Physical Functional Status
Study	Population	Procedure	Functional Status Source	Outcome Data Source	Significant Findings*
Kapoor(current)	24,051 veterans aged 65+	THR, TKR	VR-12 PCS within 6 months of surgery	Hospitalization and 90 days postop in- or outpatient VA follow-up	PCS 2–23 1.65 (0.96–2.85) PCS 24–31 1.50 (0.85–2.64) PCS 31–38 1.28 (0.67–2.46)
Sasaki24	102 women mean age = 65	Total hip arthroplasty	Prospective timed Up and Go (TUG) measure	Initial hospitalization	Difference in average time to complete TUG was statistically significant (patients with vs. without VTE)

Abbreviations: preop = preoperative, postop=postoperative, THR= total hip replacement, TKR=total knee replacement, HFS = hip fracture surgery, COPD= chronic obstructive pulmonary disease, CHF= congestive heart failure, CAD= coronary artery disease, MI= myocardial infarction, VTE = venous thromboembolism, VR-12 PCS= Veteran Rand-12 Physical Component Score¹³ which resembles closely the Short-Form 12¹² ICD-9-CM= international classification of diseases 9^th edition clinical modification

^*Findings include excess risk associated with individual comorbid conditions or functional status expressed as an odds ratio with 95% confidence interval contained within parentheses. In the case of functional status, reference category is PCS <38.

^€Comorbidities and co-occurring comorbidities in this study were modeled as stand-alone conditions compared with individuals without any of the other analyzed conditions (CAD, CHF, COPD, CVD, DM)

^†Included previous myocardial infarction, congestive heart failure, and / or stroke; comorbidity information only determined by prior hospitalizations.

^‡Chronic pulmonary disease, connective tissue diseases, or peptic ulcers (as a combined group)

^¥Only the risk ratio reported in this study