This is retrospective study of more than 3000 patients that sought to determine the incidence and risk factors of thrombotic and bleeding events in patients undergoing major orthopedic surgery. Despite the known limitations of a retrospective study, it is interesting to learn that the overall incidence of myocardial infarction and major bleeding were 5.8% and 5.4%, respectively. It is worthwhile to note that coronary artery disease and cancer were independent predictors of both myocardial necrosis and major bleeding. Over 25% of patients were transfused, but it appears that transfusion was not included in the bivariate and multivariate analysis. This is unfortunate because a recent prospective study shows that transfusion is an important predictive factor for thrombotic and cardiovascular complications.
– Elvira Bisbe