Preoperative Prevalence of and Risk Factors for Venous Thromboembolism in Patients with a Hip Fracture

Shin, Won Chul; Woo, Seung Hun; Lee, Seungjun; Lee, Jung Sub; Kim, Choongrak; Suh, Kuen Tak

doi:10.2106/jbjs.15.01329

Cited by 75 publications

(107 citation statements)

References 24 publications

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“…22 Similarly, patients with traumatic hip fractures are at higher risk for VTE both preoperatively and postoperatively. 23,24 The increased risk is mediated by immobility during and after the surgery as well as by direct venous injury and inflammation during surgery. Pharmacologic thromboprophylaxis is preferred over mechanical thromboprophylaxis and reduces the incidence of DVT and PE in the postoperative period.…”

Section: Acquired Risk Factorsmentioning

confidence: 99%

Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism

Turetz

Sideris

Friedman

et al. 2018

Semin intervent Radiol

148

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Pulmonary embolism (PE) is a common and potentially deadly form of venous thromboembolic disease. It is the third most common cause of cardiovascular death and is associated with multiple inherited and acquired risk factors as well as advanced age. The prognosis from PE depends on the degree of obstruction and hemodynamic effects of PE and understanding the pathophysiology helps in risk-stratifying patients and determining treatment. Though the natural history of thrombus is resolution, a subset of patients have chronic residual thrombus, contributing to the post-PE syndrome.

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Section: Acquired Risk Factorsmentioning

confidence: 99%

Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism

Turetz

Sideris

Friedman

et al. 2018

Semin intervent Radiol

148

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“…There are few studies that directly identify the incidence and importance of DVT in the uninjured limb in patients with lower extremity fractures. Most previous research analysed the distribution of DVT in the injured limb across the different fractures [3], or risk factors contributing to a DVT in the injured limb during the hospital stay [8]. Song et al [5] reported the changes in DVT in the injured limb in 119 patients and found a high incidence of preoperative DVT in patients [5].…”

Section: Discussionmentioning

confidence: 99%

“…The delay may result from preoperative medical evaluation and optimization or transfer from community hospitals to tertiary-care facilities. Elderly patients tend to be sicker on admission and therefore more likely to require more time for preoperative preparation [8,9]. The delays in surgical intervention may predispose patients to developing thromboembolic problems and may be related to the uninjured limb thromboembolic problems.…”

Section: Discussionmentioning

confidence: 99%

Deep Vein Thrombosis in the Uninjured Limbs of Lower Extremity Fractures: A Retrospective Study of 1454 Patients

Cong

Wang

et al. 2020

Preprint

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Objective: The purpose of this study was to investigate the incidence of deep venous thrombosis (DVT) in the uninjured limb, before and after operation, in patients with lower extremity fractures.Methods: We collected the clinical data of patients with lower extremities fractures who presented at Xi’an Honghui Hospital between 1 July, 2015 and 31 October, 2017. Doppler ultrasonography was used to diagnose the DVT. Patients were examined pre- and postoperatively. The patients were then divided into a thrombosis group and a no thrombosis group according to the preoperative and postoperative ultrasonography results. The thrombosis group was defined as patients admitted to our hospital with DVT in the uninjured limb and the no thrombosis group was defined as patients without DVT in the uninjured limb. Results: This study enrolled 1454 patients who met the inclusion criteria. The incidence of preoperative DVT in the uninjured limb was 9.63% whereas the postoperative incidence was 20.29%. Age (OR=0.965, 95 CI%: 0.954 - 0.977; P≤0.001) and gender (OR=0.667, 95% CI: 0.451-0.986, P=0.042) were independent risk factors for preoperative DVT in the uninjured limb. Blood loss (OR=0.997, 95 CI%: 0.995-1.000; P=0.020), D-dimer levels at admission (OR=0.941, 95 CI%: 0.887-0.999; P=0.045), and postoperative day 5 D-dimer levels (OR=0.889, 95 CI%: 0.819-0.965; P=0.005), were independent risk factors for postoperative DVT in the uninjured limb.Conclusion: In conclusion, the actual incidence of DVT in the uninjured lower extremity after fracture may currently be underestimated and should be pay more attention.

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“…В некоторых из этих публикаций рассматриваются венозные тромбозы, развившиеся до операции, с оценкой их частоты. Лишь единичные публикации о предоперационных венозных тромбозах у пациентов с патологией опорно-двигательного аппарата сообщают о возможности операции после проведения антикоагулянтной терапии или имплантации кава-фильтра, но не содержат четких указаний, в каких ситуациях это целесообразно [15,16].…”

Section: Discussionunclassified

Venous Thromboembolism in the Patients on Anticoagulant Prophylaxis Having Indications for the Surgical Treatment of Bone and Joint Injury: the Results of a Cross-Sectional Study

Efremova¹,

Kirienko²,

Лебедев³

et al. 2018

Flebol.

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Цель исследования-изучение частоты и характера венозных тромбоэмболических осложнений (ВТЭО), выявленных на фоне проведения антикоагулянтной профилактики, у пациентов с показаниями к хирургическому вмешательству при травматическом поражении костей и крупных суставов. Материал и методы. В исследование включен 221 пациент с ВТЭО на фоне антикоагулянтной профилактики при изолированной травме костей или крупных суставов, а также множественной травме. Ультразвуковое исследование (УЗИ) венозного русла нижних конечностей выполняли в среднем через 5,0±0,6 сут после травмы. Результаты. ВТЭО зарегистрированы у 6,5% пациентов, в 2 случаях верифицирована тромбоэмболия легочной артерии. У 55,1% больных с ВТЭО имело место повреждение бедренной кости или тазобедренного сустава, у 21,4%-костей голени, у 23,5% ВТЭО были сопряжены с множественной травмой. Наиболее часто (51,3%) выявляли тромбоз в бедренноподколенном сегменте. При переломах костей голени тромботическое поражение выявляли чаще (60,1%) в тибиальном венозном сегменте, что обусловлено прямым травматическим воздействием на глубокие вены. Билатеральное поражение выявлено у 20,8% пациентов, а эмболоопасный тромбоз-у 46,2%. Заключение. На фоне адекватной антикоагулянтной профилактики ВТЭО их частота составила 6,5%. Необходимым компонентом ведения таких пациентов должно быть УЗИ венозной системы для своевременного выявления венозного тромбоза и коррекции алгоритма лечения. Ключевые слова: тромбоз глубоких вен, венозные тромбоэмболические осложнения, костная травма.

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Preoperative Prevalence of and Risk Factors for Venous Thromboembolism in Patients with a Hip Fracture

Abstract: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 75 publications

References 24 publications

Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism

Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism

Deep Vein Thrombosis in the Uninjured Limbs of Lower Extremity Fractures: A Retrospective Study of 1454 Patients

Venous Thromboembolism in the Patients on Anticoagulant Prophylaxis Having Indications for the Surgical Treatment of Bone and Joint Injury: the Results of a Cross-Sectional Study

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