Abstract
Background
Venous thromboembolism (VTE) is a serious complication following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Despite improvements with fast-track treatment protocols, 0.5% of patients still develop a VTE within 90-days postoperatively. Previously, the 5-single nucleotide polymorphism (SNP) genetic risk scores (weighted and simplified) were developed to identify people at a high risk for VTE within the general population.
Objectives
We aimed to assess whether the 5-SNP scores could be used to identify high-risk patients in a cohort of fast-track THA/TKA patients.
Methods
A subset of patients from the Lundbeck Centre for Fast-track Hip and Knee Replacement Database was included based on the availability of genetic information. The 5-SNP scores were calculated for these patients, and their discriminatory performance was determined by c-statistic. Furthermore, the 5-SNP scores were added to a simple logistic prediction model containing clinical predictors to assess the added predictive value.
Results
A total of 7753 THA and TKA procedures (6798 patients) were included in this study. The c-statistics for the weighted and simple 5-SNP scores were 0.50 (95% CI, 0.39-0.61) and 0.48 (95% CI, 0.38-0.58), respectively. For the model with clinical predictors, the c-statistic was 0.67 (95% CI, 0.56-0.77). Addition of either of the 5-SNP scores did not improve discrimination in this model.
Conclusion
These findings do not support genetic risk profiling in fast-track THA/TKA patients to predict VTE. Hence, efforts should be directed at optimizing prediction models with clinical predictors.
Venous thromboembolism (VTE) is a serious complication following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Despite improvements with fast-track treatment protocols, 0.5% of patients still develop a VTE within 90-days postoperatively. Previously, the 5-single nucleotide polymorphism (SNP) genetic risk scores (weighted and simplified) were developed to identify people at a high risk for VTE within the general population.
Objectives
We aimed to assess whether the 5-SNP scores could be used to identify high-risk patients in a cohort of fast-track THA/TKA patients.
Methods
A subset of patients from the Lundbeck Centre for Fast-track Hip and Knee Replacement Database was included based on the availability of genetic information. The 5-SNP scores were calculated for these patients, and their discriminatory performance was determined by c-statistic. Furthermore, the 5-SNP scores were added to a simple logistic prediction model containing clinical predictors to assess the added predictive value.
Results
A total of 7753 THA and TKA procedures (6798 patients) were included in this study. The c-statistics for the weighted and simple 5-SNP scores were 0.50 (95% CI, 0.39-0.61) and 0.48 (95% CI, 0.38-0.58), respectively. For the model with clinical predictors, the c-statistic was 0.67 (95% CI, 0.56-0.77). Addition of either of the 5-SNP scores did not improve discrimination in this model.
Conclusion
These findings do not support genetic risk profiling in fast-track THA/TKA patients to predict VTE. Hence, efforts should be directed at optimizing prediction models with clinical predictors.
Originalsprog | Engelsk |
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Artikelnummer | 102644 |
Tidsskrift | Research and Practice in Thrombosis and Haemostasis |
Vol/bind | 9 |
Udgave nummer | 1 |
Antal sider | 7 |
ISSN | 2475-0379 |
DOI | |
Status | Udgivet - 2025 |
Bibliografisk note
Funding Information:B.N. and S.C. received funding from The Netherlands Thrombosis Foundation (project 2020_05) for this project. C.J. received funding from Aaleris Healthcare, The Novo Nordisk Foundations, Tryg Fonden. M.S. analyzed the data and wrote the manuscript; P.P. conceptualized the study, collected the data and wrote the manuscript; C.J. collected the data and critically reviewed the manuscript; S.C. critically reviewed the manuscript; S.O. collected the data and critically reviewed the manuscript; H.K. conceptualized the study, collected the data, and critically reviewed the manuscript; B.N. conceptualized the study and critically reviewed the manuscript. P.P. received personal speakers fee from Pharmacosmos and an honorarium for consultancy work with Sanofi Aventis. C.J. received personal speakers fees and travel reimbursement from Pharmacosmos. S.C. currently serves as the Co-Editor-in-Chief at the Journal of Thrombosis and Haemostasis. M.S. S.O. H.K. and B.N. have no conflicts of interest to declare.
Funding Information:
B.N. and S.C. received funding from The Netherlands Thrombosis Foundation (project 2020_05) for this project. C.J. received funding from Aaleris Healthcare, The Novo Nordisk Foundations, Tryg Fonden.
Publisher Copyright:
© 2024 The Authors