UK Foot and Ankle Thromboembolism (UK-FATE)
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.
Author
Mangwani, Jitendra
Houchen-Wolloff, Linzy
Malhotra, Karen
Booth, Sarah
Smith, Aiden
Teece, Lucy
Mason, Lyndon W
UK FATE Collaborative
UK FATE Collaborative
Shaikh, Rabia
Alfred, Wilam
Okhifun, Imobhio
Cinar, Ece
Bua, Nelson
Vemulapalli, Krishna
Acharya, Ashok
Gadd, Richard
Money-Taylor, John
Kantharaju, Rohit
Bhosale, Abhijit
Bahri, Suchita
Broadbent, Rosie
Drummond, Isabella
Jones, Neil
Shah, Savan
Ravindrarjah, Thuwarahan
Yasen, Zaid
Singh, Kunjshri
Al-Habs, Ruqaiya
Jeyaseelan, Lucky
Habbiba, Abdullah
Walker, Thomas
Dewhurst, Maximilian
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
Houchen-Wolloff, Linzy
Malhotra, Karen
Booth, Sarah
Smith, Aiden
Teece, Lucy
Mason, Lyndon W
UK FATE Collaborative
UK FATE Collaborative
Shaikh, Rabia
Alfred, Wilam
Okhifun, Imobhio
Cinar, Ece
Bua, Nelson
Vemulapalli, Krishna
Acharya, Ashok
Gadd, Richard
Money-Taylor, John
Kantharaju, Rohit
Bhosale, Abhijit
Bahri, Suchita
Broadbent, Rosie
Drummond, Isabella
Jones, Neil
Shah, Savan
Ravindrarjah, Thuwarahan
Yasen, Zaid
Singh, Kunjshri
Al-Habs, Ruqaiya
Jeyaseelan, Lucky
Habbiba, Abdullah
Walker, Thomas
Dewhurst, Maximilian
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
Citations
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Date
2024-11-01
Type
Subject
Collections
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.
Journal / Source Title
DOI
10.1302/0301-620X.106B11.BJJ-2024-0128.R1
PMID
39481430
Publisher
Bone & Joint