Incidence of Deep Vein Thrombosis and Pulmonary Embolism after Achilles Tendon Rupture

Background The use of venous thromboembolism prophylaxis after an Achilles rupture is controversial. The rates of reported deep vein thrombosis (DVT) range from 6.3% to 34%. There is no agreement regarding prophylactic therapy after an Achilles tendon rupture. Questions/purposes We determined the overall risk of DVT and pulmonary embolism (PE) after an Achilles tendon rupture and identified potential risk factors including surgery. Patients and Methods We retrospectively reviewed a large healthcare management organization database and identified 1172 patients who had Achilles tendon ruptures. None of the patients routinely received anticoagulation. Patients were stratified into surgical versus nonsurgical group, age older than 40 years, history of congestive heart failure, previous history of DVT or PE, and BMI greater than 30. A patient was considered to have symptomatic DVT or PE related to the Achilles tendon rupture if diagnosed within 3 months from the injury or surgery. We used a multivariable analysis to identify risk factors. Results The overall rates for DVT and PE after Achilles tendon ruptures were 0.43% and 0.34%, respectively. Age older than 40 years, congestive heart failure, history of DVT or PE, obesity, and whether a patient had surgery did not predict occurrence of DVT or PE. Conclusion We found the overall incidence of symptomatic DVT and PE to be low after an Achilles tendon rupture and believe routine use of anticoagulation might be unwarranted.