Analysis on risk factors for deep vein thrombosis in patients with traumatic fractures / 中华骨科杂志

ABSTRACT

Objective To explore the incidence rate and the risk factors of deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT.Methods All of 534 Patients with fresh four extremities or pelvic fracture between January 2010 and December 2013 were involved in this study.The incidence of DVT under 5 risk factors including general state, injury type, fracture condition, operation and laboratory examination were analyzed.Each patient underwent three Doppler ultrasound exams in actions as the epidemiology diagnostic criterion for DVT.Results The total incidence rate of DVT in 534 patients was 11.99％.The univariate analysis showed that male patients with age≥60 years, BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension and coronary artery disease had higher incidence rate of DVT.In different injury types, the fall injury caused the highest incidence rate of DVT (45.71％).There were different DVT rates for different fracture sites, with the highest incidence rate of DVT for femur shaft fracture (20.69％).The incidence rate of DVT was 50.00％ for fractures of more than three parts, 15.29％ for fractures of two parts and only 3.98％ for sole part.The incidence rate of DVT for comminuted fractures was higher than others.The operation duration, massive transfusion during operation and general anesthesia were related with the increase of incidence of DVT.Positive ACA and enhancement of D-dimer, Fib and CRP were related with the increase of incidence of DVT.Conclusion The incidence of DVT in patients with traumatic fractures approaches a considerable level.It has relationships with age≥60 years, BMI≥25 kg/m2, history of smoking, fall injury, fracture of femoral shaft and hip, more than three parts of fractures, comminuted fractures, operation duration≥2 hours, largely blood transfused, massive transfusion during operation, general anesthesia, positive ACA, enhancement of D-dimer, Fib and CRP.The surgeons should recognize the importance to prevent DVT and PE in the traumatic patients.