Clinical predictors for deep vein thrombosis on admission in patients with intertrochanteric fractures: a retrospective study

Fan, Jixing; Zhou, Fang; Xu, Xiangyu; Zhang, Zhishan; Tian, Yun; Ji, Hongquan; Guo, Yan; Lv, Yang; Yang, Zhongwei; Hou, Guojin

doi:10.1186/s12891-021-04196-7

Cited by 16 publications

(15 citation statements)

References 26 publications

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“…17 In addition to high morbidity and mortality, lower extremity DVT is a common complication in hip fracture patients, and reported incidence rates as high as 11.1-35.0%. [18][19][20][21][22] Likewise, the incidence of asymptomatic and symptomatic PE was not low, reaching up to 18.9% and 0.2%, respectively. 23,24 After the development of VTE, length of stay and total cost increased approximately two-fold, 25 and significantly decreased patients' survival rate.…”

Section: Introductionmentioning

confidence: 95%

Low Mean Platelet Volume is Associated with Deep Vein Thrombosis in Older Patients with Hip Fracture

Wang

Chen

et al. 2022

Clin Appl Thromb Hemost

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This study aimed to explore the association between mean platelet volume (MPV) and preoperative deep vein thrombosis (DVT) in older patients with hip fracture. A total of 352 consecutive older patients with hip fracture were included from January 2014 to December 2020. MPV values were measured on admission, and color Doppler ultrasonography was performed for DVT screening before the planned surgery. The receiver operating characteristic (ROC) curve was used to establish the optimal cut-off value for the prediction of DVT. Univariate and multivariate logistic regression analysis were used to examine the association between factors and DVT. The overall prevalence of preoperative DVT was 15.1%, and patients with DVT had a lower value of MPV than non-DVT patients (11.6 ± 1.2 fL vs 12.3 ± 1.4 fL, P < .01). The cut-off point according to the ROC curve for MPV was 13.3 fL, and multivariate logistic regression analysis showed that MPV level < 13.3 fL was significantly associated with an increased risk of DVT (OR = 4.857, 95% CI: 1.091-21.617, P = .038), and with every 1.0 fL decrease in MPV, the risk increased by 27.7% (OR = 1.277, 95% CI: 1.001-1.629, P = .047). Our findings indicate that a low MPV level is associated with DVT in older patients with hip fracture. As MPV is a simple indicator that can be calculated from the blood routine test, it may be a potential biomarker of DVT with the combination of other tests, further studies are needed to confirm these results.

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Section: Introductionmentioning

confidence: 95%

Low Mean Platelet Volume is Associated with Deep Vein Thrombosis in Older Patients with Hip Fracture

Wang

Chen

et al. 2022

Clin Appl Thromb Hemost

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“…We firstly found that the incidence of preoperative DVT after hip fracture was 19.0%, which was consistent with other studies. 22,23 Most importantly, a high monocyte count was independently associated with an increased risk of DVT even after adjustment for potential confounders.…”

Section: Discussionmentioning

confidence: 96%

“…Many studies have reported a high incidence of preoperative DVT after acute hip fracture, ranging from 10.2% to 35.0%. 14,16,[21][22][23] On the basis of the hip fracture database that established by our team, 24 we aimed to investigate the relationship between monocyte count and preoperative DVT in these patients.…”

Section: Introductionmentioning

confidence: 99%

Association Between Monocyte Count and Preoperative Deep Venous Thrombosis in Older Patients with hip Fracture: A Retrospective Study

Wang

Zhou

Liu

et al. 2022

Clin Appl Thromb Hemost

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Purpose To analyze the relationship between monocyte count and preoperative deep venous thrombosis (DVT) in older patients with hip fracture. Methods Consecutive older patients with hip fracture undergoing surgery were included from January 2014 to December 2021. Monocyte count was measured on admission, and Doppler ultrasonography was performed for DVT screening prior to surgery. Univariate and multivariate logistic regression analyses were used to assess the association between monocyte count and DVT. Results A total of 674 patients were finally included, and 128 patients (19.0%) were diagnosed with preoperative DVT. Patients with DVT exhibited a higher monocyte count than patients without DVT [0.55 (0.43-0.72) × 109/L versus 0.49 (0.38-0.63) × 109/L, P = 0.007]. Multivariate logistic regression analysis showed that a high monocyte count (> 0.6 × 109/L) was independently associated with a higher risk of DVT (OR = 1.705, 95% CI: 1.121-2.593, P = 0.013), and for every 0.1 × 109/L increase in monocyte count, the risk of DVT increased by 8.5% (OR = 1.085, 95% CI: 1.003-1.174, P = 0.041). Other risk factors associated with DVT included intertrochanteric fracture (OR = 1.596, 95% CI: 1.022-2.492, P = 0.040), and elevated fibrinogen level (OR = 1.236, 95% CI: 1.029-1.484, P = 0.023). Conclusion A high monocyte count is associated with an increased risk of DVT in older patients with hip fracture. Future studies should evaluate the potential role of monocyte in the prevention and treatment of thrombosis.

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“…We agree in general that the selection of explanatory variables should be based on the association with the objective variables, rather than solely on a p -value ( p < 0.10) in univariate analysis [ 9 ]. However, as for simplicity in practice, it is acceptable indeed for small sample clinical studies [ 10 , 11 ]. Stability of bone-implant after fracture fixation is related to 5 factors: bone quality, fragment geometry, fracture reduction quality, implant selection, and implant placement.…”

Section: Fourth Is the Selection Of Parameters In Multivariable Analysismentioning

confidence: 99%

In response to letter to the editor: calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures

Chang

Mao

et al. 2022

BMC Musculoskelet Disord

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We appreciate the interest by Drs. Hagiyama and coauthors in our work entitled “Calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures”. They discussed several pertinent points and it is our pleasure to respond their concerns in order. Firstly, we agree that calcar fracture gap and anteromedial cortical support are different concepts, though both of them were used to evaluate the displacement of fracture reduction quality. Secondly, our primary outcome parameter was the threshold distance of calcar fracture gapping in anteroposterior and lateral fluoroscopies, which was calculated based on sensitivity and specificity by receiver operating characteristic curves. Thirdly, we took immediate post-operative fluoroscopic images in 3 views to describe the initial reduction quality as baseline to compare and calculate the changes with three-dimensional computed tomography, which was taken about one week after operation for confirming secondary stability after head-neck sliding and impaction. Lastly, the parameters selected in multivariable analysis. Future work with better study-design is needed to improve the prediction of patient outcomes.

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Clinical predictors for deep vein thrombosis on admission in patients with intertrochanteric fractures: a retrospective study

Cited by 16 publications

References 26 publications

Low Mean Platelet Volume is Associated with Deep Vein Thrombosis in Older Patients with Hip Fracture

Low Mean Platelet Volume is Associated with Deep Vein Thrombosis in Older Patients with Hip Fracture

Association Between Monocyte Count and Preoperative Deep Venous Thrombosis in Older Patients with hip Fracture: A Retrospective Study

In response to letter to the editor: calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures

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