Muscular Calf Vein Thrombosis Is Associated With Increased 30-Day Mortality But Not 90-Day Mortality in Older Patients With Hip Fracture

Chen, Xi; Wang, Zhicong; Liu, Hailong; Zhang, Jianjun; Zhu, Zhonglun; Chen, Yan; Liu, Mozhen; Zhou, Qing

doi:10.1016/j.amjcard.2022.08.018

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…Previous studies have also found no signi cant association between CMVT and mortality [25,26]. It has also been reported that CMVT in geriatric hip fracture patients is associated with increased mortality at thirty days postoperatively, but disappeared at ninety days follow-up [12]. We believe that the difference in mortality at one month postoperatively may be related to the perioperative management and quality of care in different hospitals, and the underlying conditions of the patients included.…”

Section: Discussionmentioning

confidence: 63%

“…The primary outcome measures were mortality within one year after undergoing hip fracture surgery. The one-month postoperative observation window is the most common follow-up period in the literature [11,12]. Considering the temporal correlation between the surgical delay and the development of complications, longer follow-up periods of three-month, six-month, and one-year were also analyzed.…”

Section: Outcome Measuresmentioning

confidence: 99%

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The effect of calf muscular vein thrombosis on the prognosis within one year postoperatively of geriatric hip fracture patients: a propensity score-matched analysis

Jiang

Xing

Luo

et al. 2023

Preprint

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Introduction: Calf muscular vein thrombosis (CMVT) is a type of distal deep vein thrombosis, which is common in geriatric hip fracture patients. However, studies focusing on whether the orthopedic operation has an impact on the prognosis of geriatric hip fracture patients with CMVT are very limited. Therefore, the aim of this study was to explore whether geriatric hip fractures with CMVT affect the mortality of patients within one year postoperatively. The difficulty of the operation, postoperative complications, the status of thrombosis, and long-term function were also compared. Materials and Methods Geriatric hip fracture patients who underwent surgery between January 2019 and January 2021 were included. Patients were divided into groups with and without CMVT by preoperative color Doppler ultrasound examination. Propensity score-matching (PSM) was performed in a ratio of 1:1 between the patient with and without CMVT groups. Baseline characteristics, laboratory results, perioperative indicators and prognosis of patients were collected retrospectively. Intraoperative and long-term postoperative comparisons were conducted between patients with and without CMVT. Results Two hundred and sixty geriatric hip fracture patients were included. Eighty-nine patients in each group were matched after PSM. There was no significant difference in mortality between the two groups at one-month, three-month, six-month, and one-year postoperatively. However, patients with CMVT had longer hospital stays, a higher incidence of postoperative complications, and a higher incidence of thrombosis progression than patients without CMVT in long-term follow-up. Conclusion CMVT in Chinese geriatric hip fracture patients is not associated with mortality within one year postoperatively. In addition, when orthopedic surgeons treat geriatric hip fracture patients with CMVT, enhanced postoperative rehabilitation, meticulous nursing, and thrombosis management are recommended to achieve better clinical outcomes and long-term prognosis. Trial registration: Chinese Clinical Trial Registry (ChiCTR2300069411). Registered March 15, 2023, https://www.chictr.org.cn/showproj.html?proj=192079

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Section: Discussionmentioning

confidence: 63%

Section: Outcome Measuresmentioning

confidence: 99%

The effect of calf muscular vein thrombosis on the prognosis within one year postoperatively of geriatric hip fracture patients: a propensity score-matched analysis

Jiang

Xing

Luo

et al. 2023

Preprint

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“…As described above, these blood indicators were significant predictors of death after hip fracture ( 10 , 13 – 15 ). Furthermore, we also found that high monocyte level was associated with an increased risk of deep venous thrombosis (DVT) in older patients with hip fracture, thereby leading to a 3.21-fold increase in the 30-day mortality ( 29 , 30 ). From these findings, we hypothesized that high SIRI level would be an independent predictor of subsequent death following hip fracture.…”

Section: Introductionmentioning

confidence: 86%

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Fang,

Gao,

Wang

et al. 2024

Front. Med.

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ObjectiveWith a rapidly aging global population, the assessment of mortality risk following hip fracture in older adults has received increasing attention. Recently, the system inflammation response index (SIRI) has been identified as a novel prognostic marker to reflect both systemic inflammation and immune status. However, it is not yet known whether SIRI is a potential predictor of subsequent death in hip fracture patients. Therefore, this study aimed to investigate the association between SIRI and mortality in older patients with hip fracture.MethodsA total of 1,206 older hip fracture patients undergoing surgery between January 2013 and December 2022 were consecutively derived from our longitudinal database. Patients were divided into three groups according to SIRI tertiles, calculated as neutrophil × monocyte / lymphocyte. Survival status was obtained from medical records or telephone interviews, and the study outcome was all-cause mortality after hip fracture at the longest follow-up. Multivariate Cox proportional hazard model and restricted cubic spline (RCS) regression model were used to evaluate the association between SIRI and mortality. Moreover, a series of sensitivity analyses were conducted to further validate the robustness of the association.ResultsDuring a median follow-up of 43.85 months, 337 patients (27.94%) died. After full adjustment, each unit increase in SIRI was significantly associated with a 2.2% increase in overall mortality (95% confidence interval [CI]: 1.001–1.042, p = 0.029). Similarly, compared with the first tertile of SIRI, the second and third tertile showed a 1.335-fold (95% CI: 1.011–1.762, p = 0.042) and 1.447-fold (95% CI, 1.093–1.917, p = 0.010) higher risk of death. Sensitivity analyses confirmed the stability of the association. Moreover, RCS analysis revealed a positive non-linear relationship between SIRI and mortality (P for nonlinearity = 0.021).ConclusionHigh SIRI level at admission was significantly and positively associated with an increased risk of death, suggesting that SIRI may be an independent predictor of mortality in older patients with hip fracture.

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“…Once DVT and PE occur, it can seriously endanger patient safety. Literature has demonstrated that CMVT is independently associated with a higher risk of 30‐day mortality in elderly patients with hip fractures 8 . Zhuang et al 9 evaluated the influencing factors of new‐onset CMVT after hip fractures surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Literature has demonstrated that CMVT is independently associated with a higher risk of 30‐day mortality in elderly patients with hip fractures. 8 Zhuang et al 9 evaluated the influencing factors of new‐onset CMVT after hip fractures surgery. However, it is unclear which factors in elderly patients with hip fractures increase the risk of CMVT before surgery.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Prevalence and Risk Factors For Calf Muscular Vein Thrombosis in Elderly Patients with Hip Fracture

Pan,

Zhou,

Ruze

et al. 2023

Orthopaedic Surgery

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Objective: Increasing evidence has shown that calf muscular vein thrombosis (CMVT) can develop into proximal deep vein thrombosis, even causing pulmonary embolism. However, opinions about the prevalence and risk factors are still controversial. This study aimed to investigate the prevalence and risk factors for CMVT in elderly patients with hip fractures to facilitate their preoperative management. Methods:We included 419 elderly patients with hip fracture who were treated in the orthopaedic department of our hospital from June 2017 to December 2020. The patients were divided into CMVT and non-CMVT groups based on color Doppler ultrasound screening of the venous system in the lower extremities. Clinical data, such as age, sex, body mass index, time from injury to admission, and laboratory data were collected. Univariate and multivariate logistic regression analyses were performed to determine independent risk factors for CMVT. A receiver operating characteristic curve was used to analyze the predictive effectiveness of the model. Finally, the clinical utility of the model was analyzed using decision curve analysis and clinical impact curves. Results:The prevalence of preoperative CMVT was 30.5% (128/419). Independent predictors of preoperative CMVT identified by univariate and multivariate logistic regression analyses were sex, time from injury to admission, American Society of Anesthesiologists (ASA) classification, C-reactive protein (CRP) level, and D-dimer level (p < 0.05). The area under curve (AUC) was 0.750 (95% CI: 0.699-0.800, p < 0.001) and the sensitivity and specificity were 0.698 and 0.711, respectively, which meant the prediction model has a good efficacy in the prediction of CMVT risk. In addition, the fitting degree of the prediction model was also good (Hosmer-Lemeshow χ 2 = 8.447, p > 0.05). The clinical utility of the model was verified using decision curve analysis and clinical impact curves. Conclusion:Sex, time from injury to admission, ASA classification, CRP level, and D-dimer levels are independent preoperative predictors of CMVT in elderly patients with hip fractures. Measures should be taken for patients with these risk factors to prevent the occurrence and deterioration of CMVT.

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Muscular Calf Vein Thrombosis Is Associated With Increased 30-Day Mortality But Not 90-Day Mortality in Older Patients With Hip Fracture

Cited by 4 publications

References 24 publications

The effect of calf muscular vein thrombosis on the prognosis within one year postoperatively of geriatric hip fracture patients: a propensity score-matched analysis

The effect of calf muscular vein thrombosis on the prognosis within one year postoperatively of geriatric hip fracture patients: a propensity score-matched analysis

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Preoperative Prevalence and Risk Factors For Calf Muscular Vein Thrombosis in Elderly Patients with Hip Fracture

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