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Introduction: Venous thromboembolism (VTE) is a relatively uncommon but potentially fatal complication following total knee arthroplasty (TKA). High altitude may induce physiological changes that can predispose patients to VTE. The purpose of this study was to determine if high altitude is an independent risk factor for postoperative VTE following TKA.
Methods: A large claims database was queried for patients who underwent TKA at high elevation (≥ 4,000 feet) and low elevation (≤ 100 feet) using Current Procedural Terminology (CPT) codes, International Classification of Disease (ICD) codes, and zip codes. High- and low-altitude cohorts were matched 1:3 by 5-year age range, sex, Charlson comorbidity index (CCI), and comorbidities including diabetes mellitus, obesity (BMI [body mass index] ≥ 30), hypertension, and tobacco use. There were 57,135 patients included in the high-altitude group and 171,322 in the low-altitude group. Outcome measures included 30- and 90-day incidence of VTE, deep venous thrombosis (DVT), and pulmonary embolism (PE). Chi-square tests were used to determine differences in demographics between cohorts. Binomial logistic regression analysis was used to determine postoperative rates of VTE, DVT, and PE.
Results: The incidence of VTE was significantly higher for the high-altitude group than the low-altitude group at 30 days (OR [odds ratio] 1.15 [95% CI (confidence interval) 1.02 to 1.30], P = 0.022) and 90 days follow-up (OR 1.20 [95% CI 1.08 to 1.34], P = 0.0007). The incidence of DVT was significantly higher for the high-altitude cohort at both 30- (OR 1.30 [95% CI 1.10 to 1.54], P = 0.002) and 90-days postoperatively (OR 1.36 [95% CI 1.18 to 1.57], P < 0.0001). The incidence of PE within 30 and 90 days was not significantly different between groups.
Conclusions: High altitude (> 4,000 feet) is an independent risk factor for VTE following TKA. Patients who undergo TKA at surgical centers greater than 4,000 feet in elevation are more likely to develop VTE and DVT within 30- and 90 days postoperatively. Surgeons may account for high altitude as a risk factor and determine the most suitable postoperative prophylaxis method for their patients.
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http://dx.doi.org/10.1016/j.arth.2024.12.022 | DOI Listing |
J Cosmet Dermatol
December 2024
Department of Plastic Surgery, Affiliated Calmette Hospital of Kunming Medical University, Kunming, China.
Background: The Yunnan-Guizhou Plateau's high-altitude setting is characterized by intense solar ultraviolet radiation, a significant environmental stressor that frequently leads to skin barrier damage. This damage presents clinically as erythema, itching, and desquamation, underscoring the need for effective reparative interventions.
Aims: The objective of this study was to assess the therapeutic efficacy of a novel treatment protocol that integrates non-crosslinked hyaluronic acid (HA) injection with microneedle application of human epidermal growth factor (hEGF) for the restoration of skin barrier function in regions of high altitude.
Front Physiol
December 2024
Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, China.
Background: The low-pressure, hypoxic environment characteristic of high-altitude regions significantly affects the cardiovascular and autonomic nervous system functions of individuals, consequently impairing their sleep quality. Heart rate variability, a non-invasive indicator of autonomic nervous system activity and balance within the cardiovascular system, has not been thoroughly investigated in terms of its patterns during acclimatization and de-acclimatization phases for individuals traveling to and residing in high-altitude areas and its relationship with sleep stability.
Methods: Data was collected from 22 medical staff members who traveled from Chengdu to Yecheng, with measurements taken before leaving Chengdu, 1 week in Yecheng, 3 months in Yecheng, and 1 week after returning to Chengdu.
Front Vet Sci
December 2024
Gansu Key Laboratory of Herbivorous Animal Biotechnology, Faculty of Animal Science and Technology, Gansu Agricultural University, Lanzhou, China.
After prolonged adaptation to high-altitude environments, Tibetan sheep have developed a robust capacity to withstand hypobaric hypoxia. Compared to low-altitude sheep, various organs and tissues in Tibetan sheep have undergone significant adaptive remodeling, particularly in the lungs. However, whether lambs and adult Tibetan sheep exhibit similar adaptations to high-altitude hypoxia remains unclear.
View Article and Find Full Text PDFPhysiol Genomics
December 2024
Centre of Excellence for Applied Development of Ayurveda Prakriti and Genomics, CSIR-Institute of Genomics & Integrative Biology, Delhi, India.
The regulation of oxygen homeostasis is critical in physiology and disease pathogenesis. High Altitude environment or hypoxia (lack of oxygen) can lead to adverse health conditions such as HAPE despite initial adaptive physiological responses. Studying genetic, hematological and biochemical, and the physiological outcomes of hypoxia together could yield a comprehensive understanding and potentially uncover valuable biomarkers for predicting responses.
View Article and Find Full Text PDFNitrogen emissions up to the standard are a major challenge for wastewater treatment plants in alpine and high-altitude areas. The dosing of carriers can improve the nitrogen removal efficiency of the system at low temperatures; however, the mechanism of action of sludge and biofilm in nitrogen removal remains unclear. This study elucidated the internal mechanism of nitrogen removal via the function of microbial metabolism in sludge and biofilm at low temperatures.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!