Deep vein thrombosis in the lower extremities after femoral neck fracture: A retrospective observational study

Fu, Yan; Liu, Ping; Xu, Xin; Wang, Pengfei; Shang, Kun; Ke, Chao; Fei, Chen; Yang, Kun; Zhang, Bin-Fei; Zhuang, Yan

doi:10.1177/2309499019901172

Cited by 34 publications

(43 citation statements)

References 27 publications

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“…Most of the patients with femoral and pelvic fractures are at high risk of venous thromboembolism (VTE) due to hypercoagulable state [ 1 ], trauma and surgical injury, prolonged immobilization, and edema of surrounding tissues, for example, the incidence of preoperative DVT and the postoperative DVT in femoral neck fracture was 32% and 56% respectively [ 2 ]. Previous studies have focused on the analysis and prevention of DVT risk factors after fracture surgery, and seldom focused on the analysis of risk factors before, during and after the entire perioperative period.…”

Section: Introductionmentioning

confidence: 99%

Analysis of perioperative risk factors for deep vein thrombosis in patients with femoral and pelvic fractures

Cheng

2020

J Orthop Surg Res

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Objective Clinical characteristics, anticoagulant protocols, and risk factors of deep vein thrombosis (DVT) in patients with femoral and pelvic fractures were analyzed throughout the perioperative period to provide references for early identification and optimization of risk factors. Methods This was a retrospective study. A total of 569 patients undergoing surgery of femoral and pelvic fractures from May 2018 to December 2019 were included. The clinical data including general conditions, trauma, surgery, anticoagulant protocols, and laboratory indexes were collected. According to the results of deep vein Doppler ultrasonography of the lower extremities, the patients were divided into non-DVT group and DVT group. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors of preoperative and postoperative DVT. Results The incidence of DVT was 40.25% and preoperative DVT was 26.71%, which was higher than the incidence of postoperative DVT of 17.22%. Most of them were thrombus on the affected side (60.26%) and distal thrombus (81.66%). The average time of DVT formation was 6.55 ± 0.47 days after trauma and 6.67 ± 0.48 days after surgery. Chronic obstructive pulmonary disease (COPD), anemia, hypoproteinemia, non-anticoagulation before surgery, delayed anticoagulation after trauma and admission, high-energy trauma, multiple injuries, drinking history, and advanced age were independent risk factors for perioperative DVT. The increased level of fibrinogen degradation products was an independent risk factor for preoperative DVT. These risk factors were identified to be independently associated with postoperative DVT, including intraoperative blood transfusion, postoperative blood transfusion, pulmonary infection, preoperative non-anticoagulation, postoperative delayed anticoagulation, preoperative waiting time > 7 days, operative time > 2 h, c-reactive protein, fibrinogen level, platelet count 1 day after surgery, c-reactive protein, fibrinogen, and hemoglobin levels 3 days after surgery, comminuted fracture. Conclusions At present, anticoagulation and other DVT prevention and treatment programs have not changed the current situation that the incidence of DVT is still high. Through the analysis of the risk factors of DVT throughout the perioperative period, optimizing the perioperative blood transfusion, preoperative lung disease, hypoproteinemia, anemia, inflammation, etc., and surgery as soon as possible after trauma may further reduce its incidence.

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Section: Introductionmentioning

confidence: 99%

Analysis of perioperative risk factors for deep vein thrombosis in patients with femoral and pelvic fractures

Cheng

2020

J Orthop Surg Res

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“…Chung et al found that the risk of VTE in diabetic patients is 1.44 times higher than that in non-diabetic patients [18] . The ndings of Fu et al [2] and Kang et al [19] also indicated that diabetes increases the risk of DVT. The results of the present study revealed that the prevalence of DVT was signi cantly higher in the diabetic group than in the non-diabetic group (6.2%:5.2%).…”

Section: Discussionmentioning

confidence: 92%

“…Deep vein thrombosis (DVT) is a common complication after trauma, especially after lower extremity fractures [1] . The incidence of preoperative DVT has been reported to be as high as 32% [2] . Underlying fatal effects, such as pulmonary embolism (PE), can be caused by DVT, and research has shown that patients treated for venous thromboembolism (VTE) have approximately twice the length of stay and the total cost of hospitalization as those not treated for VTE [3] .…”

Section: Introductionmentioning

confidence: 99%

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Study on the Risk Factors of Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

Chang

Wang

et al. 2020

Preprint

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Abstract Background:The objective of this work is to discuss and analyze the related factors of lower extremity fracture complicated by deep vein thrombosis (DVT), and to help surgeons aptly prevent it.Methods:A retrospective analysis was conducted on the orthopedic inpatient records of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2014 to November 2018, and 11,891 patients with closed fractures of lower extremities were selected.By analyzing each patient's gender, age, presence or absence of diabetes and hypertension,preoperative plasma D-dimer level, and color Doppler ultrasound of the lower extremity vein, the pertinent factors of the patients with lower extremity fractures complicated by DVT were analyzed.Results: A total of 11,891 patients were selected, including 4462 with cases of peri-hip fractures, 754with cases of femoral shaft fractures, 1776 with cases of peri-knee fractures, 1961 with cases of tibiofibular fractures, and 2938 with cases of ankle fractures.Of these patients, 643 with DVT were detected, displaying a total incidence of 5.4%.All patients were categorized into either the DVT group or non-DVT group.The results demonstrate that there were statistically significant differences between the two groups in age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level (p<0.05), but there was no statistically significant difference in sex (p>0.05). Logistic multivariate analysis revealed that age, the presence of diabetes, and the preoperative plasma D-dimer level of patients were independent risk factors for lower extremity fracture complicated by DVT.Conclusion: Age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level were found to be correlated with the incidence of DVT. Moreover,age, the presence of diabetes, the preoperative fracture site, and the plasma D-dimer level were found to be independent risk factors.

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“…Most of the patients with femoral and pelvic fractures are at high risk of Venous thromboembolism(VTE) due to hypercoagulable state [1] , trauma and surgical injury, prolonged immobilization and edema of surrounding tissues,for example, the incidence of preoperative DVT and the postoperative DVT in femoral neck fracture was 32% and 56% respectively [2] .Previous studies focused more on the analysis and prevention of DVT risk factors after fracture surgery, and less on the analysis of risk factors during the whole perioperative period, including pre-operation,introoperation and post-operation.For example, the in uence of preoperative risk factors including chronic obstructive pulmonary disease, pulmonary infection, hypoproteinemia and perioperative blood transfusion on the occurrence and development of DVT. Secondly, anticoagulation therapy, early activities, and lower extremity pneumatic therapy are the main measures for the prevention and treatment of DVT.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Perioperative Risk Factors for Deep Vein Thrombosis in Patients With Femoral and Pelvic Fractures

Cheng

2020

Preprint

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Objective: Clinical characteristics, anticoagulant protocols and risk factors of deep Vein thrombosis (DVT) in patients with femoral and pelvic fractures were analyzed throughout the perioperative period to provide references for early identification and optimization of risk factors.Methods: This was a retrospective study. A total of 569 patients undergoing surgery of femoral and pelvic fractures from May 2018 to December 2019 were included. The Clinical data including general conditions,trauma, surgery,anticoagulant protocols and laboratory indexes were collected.According to the results of deep vein Doppler ultrasonography of the lower extremities, the patients were divided into non-DVT group and DVT group.Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors of preoperative and postoperative DVT.Results: The incidence of DVT was 40.25%, PE was 1.93%, and preoperative DVT was 26.71%,which was higher than the incidence of postoperative DVT of 17.22%. Most of them were thrombus on the affected side (60.26%) and distal thrombus (81.66%).The average time of DVT formation was 6.55±0.47 days after trauma and 6.67±0.48 days after surgery. Chronic obstructive pulmonary disease(COPD), anemia, hypoproteinemia, non-anticoagulation before surgery, delayed anticoagulation after trauma and admission, high energy trauma, multiple injuries, drinking history, and advanced age were independent risk factors for perioperative DVT.The increased level of fibrinogen degradation products was an independent risk factor for preoperative DVT. These risk factors were identified to be independently associated with postoperative DVT, including intraoperative blood transfusion, postoperative blood transfusion, pulmonary infection, preoperative non-anticoagulation, postoperative delayed anticoagulation, preoperative waiting time > 7d, operative time > 2h, c-reactive protein, fibrinogen level, platelet count 1 day after surgery, c-reactive protein, fibrinogen, and hemoglobin levels 3 days after surgery, comminuted fracture.Conclusions: At present, anticoagulation and other DVT prevention and treatment programs have not changed the current situation that the incidence of DVT is still high. Through the analysis of the risk factors of DVT throughout the perioperative period, optimizing the perioperative blood transfusion, preoperative lung disease, hypoproteinemia, anemia, inflammation, etc., and surgery as soon as possible after trauma may further reduce its incidence.

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Deep vein thrombosis in the lower extremities after femoral neck fracture: A retrospective observational study

Cited by 34 publications

References 27 publications

Analysis of perioperative risk factors for deep vein thrombosis in patients with femoral and pelvic fractures

Analysis of perioperative risk factors for deep vein thrombosis in patients with femoral and pelvic fractures

Study on the Risk Factors of Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

Analysis of Perioperative Risk Factors for Deep Vein Thrombosis in Patients With Femoral and Pelvic Fractures

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