Performing total shoulder arthroplasty in higher altitudes was associated with a 40-fold increased pulmonary embolism risk, according to research presented at the 2019 Annual Meeting of the American Academy of Orthopaedic Surgeons in Las Vegas, March 12-16, and reported in MedPage Today.
Researchers analyzed a Medicare database with 6,948 patients who underwent total shoulder arthroplasties between 2005 and 2014. Patients underwent the procedure at altitudes between 4,000 feet and 7,016 feet and at altitudes under 100 feet. They also examined deep vein thrombosis incidence, but there was no statistically significant difference in DVT counts between the groups at 90 days postoperatively.
Three things to know:
1. Nineteen of the high-altitude patients suffered pulmonary embolism within 30 days postoperatively, while no patients who were treated near sea level did.
2. At 90 days postoperatively, there were 28 pulmonary embolisms in the high-altitude group compared with 14 in the low-altitude group.
3. Altitudes as low as 4,000 feet were associated with heightened pulmonary embolism risk. In the U.S., that includes sizable western cities such as Denver, Reno, Nev., Flagstaff, Ariz., and Albuquerque, N.M.