Risk factors of venous thromboembolism after lower extremity orthopedic surgery in the elderly / 中国医师杂志

ABSTRACT

Objective:To evaluate the risk factors of venous thromboembolism (VTE) after lower extremity orthopedic surgery in the elderly.Methods:The case data of 114 patients who underwent lower extremity orthopedic surgery in Jingdong Yumei Integrated Traditional Chinese and Western Medicine Kidney Disease Hospital from January 2018 to January 2019 were retrospectively collected. According to the presence or absence of VTE, they were divided into non VTE group (103 cases) and VTE group (11 cases). Univariate and multivariate logistic regression were used to analyze the independent risk factors of VTE after lower extremity surgery in the elderly. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive efficacy of independent risk factors for VTE.Results:Compared with the non VTE group, the VTE group had more male patients, less preventive application of traditional Chinese medicine, higher preoperative D-dimer levels, longer operation time and less drainage 48 hours after operation (all P<0.05). Multivariate analysis showed that long operation time was an independent risk factor for VTE ( OR=1.021, 95% CI 1.007-1.036, P=0.004), and more postoperative drainage was an independent protective factor for VTE ( OR=0.993, 95% CI 0.988-0.998, P=0.006). The AUC of VTE predicted by operation time and postoperative drainage volume were 0.691 (95% CI 0.548-0.834, P=0.038) and 0.767 (95% CI 0.679-0.856, P=0.004), respectively. The AUC of combined diagnosis of the two was 0.807 (95% CI 0.731-0.883, P=0.001). Conclusions:The operation time >107 min and the drainage volume <225 ml 48 hours after operation are independent risk factors for VTE in elderly patients undergoing lower extremity orthopedic surgery. Orthopedic doctors should try to shorten the operation time and keep the postoperative drainage unobstructed in order to reduce the incidence of VTE.