Aims 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. Methods 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. Results 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. Conclusion 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.

中文翻译：

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英国足踝血栓栓塞症 （UK-FATE）。


目的 静脉血栓栓塞 （VTE） 是足踝手术的潜在并发症。对于促成危险因素和化学预防要求缺乏共识。本研究的主要结果是分析接受足踝手术和跟腱 （TA） 断裂的患者症状性 VTE 和 VTE 相关死亡率的 90 天发生率。次要目标是评估化学预防的提供和 VTE 危险因素的差异。方法 这是一项多中心、前瞻性的全国合作审计，在参与的英国医院内对所有在手术室接受足踝手术或 TA 破裂治疗的患者收集了为期 9 个月的数据。使用单变量 logistic 回归模型评估 VTE 与血栓预防之间的关联。采用多变量 logistic 回归模型确定 VTE 风险的关键预测因子。结果 共纳入来自 68 个地点的 13,569 例患者。总体而言，有 11,363 名患者可供分析：44.79% 是择期 （n = 5,090），42.16% 是不包括 TA 破裂的创伤 （n = 4,791），3.50% 是急性糖尿病手术 （n = 398），2.44% 是接受手术的 TA 破裂 （n = 277），7.10% 是非手术治疗的 TA 破裂 （n = 807）。总共记录了 11 种化学抗凝剂，最常见的药物是低分子肝素 （n = 6,303;56.79%）。共有 32.71% 的患者未接受化学预防。有 99 例 VTE （发生率 0.87% （95% CI 0.71-1.06））。VTE 相关死亡率为 0.03% （95% CI 0.005-0.080）。 单变量分析显示，年龄增加和美国麻醉医师协会 （ASA） 分级发生 VTE 的几率更高，既往癌症、中风或 VTE 病史也更高。在多变量分析中，VTE 的最强预测因子是足踝手术类型和 ASA 分级。结论 足踝手术和 TA 管理中症状性 VTE 的 90 天发生率和 VTE 相关死亡率较低。使用的化学预防存在显着差异。与 90 d 症状性 VTE 相关的显著危险因素是 TA 破裂和高 ASA 分级。