venous thromboembolism and bleeding after total knee and hip arthroplasty findings from the spanish national discharge database the impact of venous thromboembolism vte and bleeding in patients undergoing major joint surgery has not been thoroughly studied the spanish national discharge database during the years 20052006 was used to assess the frequency and clinical impact of vte and bleeding after elective total knee tka or hip tha arthroplasty of 58037 patients undergoing tka 018 95 confidence interval ci 015022 were diagnosed with pulmonary embolism pe 057 95 ci 051063 with deepvein thrombosis dvt 120 95 ci 112130 had bleeding complications and 009 95 ci 007012 died of 54 patients who died 204 95 ci 107354 had been diagnosed with pe 370 95 ci 063117 with dvt and 130 95 ci 567256 had bled of 31769 patients undergoing elective tha 023 95 ci 018029 were diagnosed with pe 044 95 ci 037052 with dvt 121 95 ci 110134 bled and 016 95 ci 012021 died of 52 patients who died 135 95 ci 608248 had been diagnosed with pe and 961 95 ci 352213 had bled on multivariable analysis pe odds ratio or 157 95 ci 75328 dvt or 63 95 ci 1527 and bleeding or 85 95 ci 3620 were independent predictors for death after tka after tha only pe or 65 95 ci 26160 and bleeding or 64 95 ci 2317 predicted the risk for death bleeding dvt and pe arising after tka were all independent predictors for death their increase in risk was however substantially higher for pe after tha only pe and bleeding independently predicted death