Incidence of and risk factors for pre-operative deep venous thrombosis in geriatric intertrochanteric fracture patients

Zhao, Kuo; Wang, Zhongzheng; Tian, Siyu; Hou, Zhiyong; Chen, Wei; Zhang, Yingze

doi:10.1007/s00264-021-05215-x

Cited by 15 publications

(24 citation statements)

References 37 publications

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“…Five studies [14,18,20,22,31] reported the relationship between injury side and preoperative DVT. The test for heterogeneity was not significant and the studies had low heterogeneity (p for heterogeneity = 0.84, I 2 = 0%).…”

Section: Injury Sidementioning

confidence: 99%

“…Preoperative DVT, which affects 8-34.9% of hip fracture patients and may be as high as 62% in those with delayed operations [10][11][12], plays a critical role in HF patients' preoperative waiting time [13]. Zhao [14] reported that delayed surgery, hypoproteinemia, three or more comorbidities, and a d-dimer level > 1.59 mg/l were predictors of preoperative DVT, while Kobayashi [15] indicated that female patients, advanced age, prolonged time from injury to admission, prolonged time from injury to surgery, and kidney disease were risk factors for preoperative DVT.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for preoperative deep venous thrombosis in hip fracture patients: a meta-analysis

et al. 2022

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Study design A meta-analysis. Background Hip fracture (HF), as common geriatric fracture, is related to increased disability and mortality. Preoperative deep vein thrombosis (DVT) is one of the most common complications in patients with hip fractures, affecting 8–34.9% of hip fracture patients. The study aimed to assess the risk factors of preoperative DVT after hip fractures by meta-analysis. Methods An extensive search of the literature was performed in the English databases of PubMed, Embase, and the Cochrane Library; and the Chinese databases of CNKI and WAN FANG. We collected possible predictors of preoperative DVT from included studies, and data analysis was conducted with RevMan 5.3 and STATA 12.0. Results A total of 26 English articles were included, and the rate of DVT was 16.6% (1627 of 9823 patients) in our study. Our findings showed that advanced age [p = 0.0003, OR = 0.13 95% CI (0.06, 0.21)], female patients [p = 0.0009, OR = 0.82 95% CI (0.72, 0.92)], high-energy injury [p = 0.009, OR = 0.58 95% CI (0.38, 0.87)], prolonged time from injury to admission [p < 0.00001, OR = 0.54 95% CI (0.44, 0.65)], prolonged time from injury to surgery [p < 0.00001, OR = 2.06, 95% CI (1.40, 2.72)], hemoglobin [p < 0.00001, OR = − 0.32 95% CI (− 0.43, − 0.21)], coronary heart disease [p = 0.006, OR = 1.25 95% CI (1.07, 1.47)], dementia [p = 0.02, OR = 1.72 95% CI (1.1, 2.67)], liver and kidney diseases [p = 0.02, OR = 1.91 95% CI (1.12, 3.25)], pulmonary disease [p = 0.02, OR = 1.55 95% CI (1.07, 2.23)], smoking [p = 0.007, OR = 1.45 95% CI (1.11, 1.89)], fibrinogen [p = 0.0005, OR = 0.20 95% CI (0.09, 0.32)], anti-platelet drug [p = 0.01, OR = 0.51 95% CI (0.30, 0.85)], C-reactive protein [p = 0.02, OR = 5.95 95% CI (1.04, 10.85)], < 35 g/l albumin [p = 0.006, OR = 1.42 95% CI (1.1, 1.82)], and thrombosis history [p < 0.00001, OR = 5.28 95% CI (2.85, 9.78)] were risk factors for preoperative DVT. Conclusions Many factors, including advanced age, female patients, high-energy injury, prolonged time from injury to admission, prolonged time from injury to surgery, patients with a history of coronary heart disease, dementia, liver and kidney diseases, pulmonary disease, smoking, and thrombosis, fibrinogen, C-reactive protein, and < 35 g/l albumin, were found to be associated with preoperative DVT. Our findings suggested that the patient with above characteristics might have preoperative DVT. Level of evidence: Level III.

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Section: Injury Sidementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for preoperative deep venous thrombosis in hip fracture patients: a meta-analysis

et al. 2022

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“…We found that the level of ALB was a risk factor for predicting DVT in lower limb fractures, which was consistent with the findings of former researchers. 33 – 35 The potential association between DVT and decreasing ALB levels could be explained by hypofibrinogenemia caused by low protein and platelet aggregability. 36 As a result, quick and efficient treatment of low protein and hyperglycemia can play an essential role in DVT prevention.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Deep Vein Thrombosis in Adults with Acute Compartment Syndrome Following Lower Extremity Fractures

Yang

Wang

Long

et al. 2023

Clin Appl Thromb Hemost

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This study aimed to identify the risk factors of deep vein thrombosis (DVT) in adults with acute compartment syndrome (ACS) following lower extremity fractures. We collected data on adults with ACS following lower extremity fractures in our hospital from November 2013 to January 2021. Patients were divided into the DVT group and the non-DVT group according to whether they had DVT or not. The demographics, comorbidities, and admission laboratory examinations were computed by univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis. In our study, the rate of DVT (26 of 110) was 23.6%. Univariate analysis showed that numerous factors were associated with the formation of DVT. Logistic regression analysis showed that patients with multiple fractures ( P = .015, OR = 5.688), patients with a history of hypertension ( P = .011, OR = 16.673), and patients with a higher BMI ( P = .008, OR = 1.950) and FDP ( P = .013, OR = 1.031) were relevant predictors of DVT. ROC curve analysis indicated 24.73 kg/m2 and 28.33 μg/mL were the cutoff values of BMI and FDP to predict the DVT, respectively. Furthermore, the combination of BMI and FDP had the highest diagnostic accuracy. Our findings identified multiple fractures, BMI, and FDP as independent risk factors for DVT in patients with ACS following lower extremity fractures and determined the cutoff values of BMI and FDP, helping us individualize the assessment of the risk of DVT to manage early targeted interventions.

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“…Moreover, recent studies included almost all blood cells for the prediction of VTE, except for monocyte count, suggesting that clinicians did not actually consider monocytes as a potential risk factor for VTE occurrence. [16][17][18] Hip fracture is a common type of fracture in older adults. Due to the rapid global aging, it is predicted that the number of hip fracture will be dramatically increased worldwide from 1.66 million in 1990 to 6.26 million in 2050.…”

Section: Introductionmentioning

confidence: 99%

“…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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Incidence of and risk factors for pre-operative deep venous thrombosis in geriatric intertrochanteric fracture patients

Cited by 15 publications

References 37 publications

Risk factors for preoperative deep venous thrombosis in hip fracture patients: a meta-analysis

Risk factors for preoperative deep venous thrombosis in hip fracture patients: a meta-analysis

Risk Factors of Deep Vein Thrombosis in Adults with Acute Compartment Syndrome Following Lower Extremity Fractures

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

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