Prevalence rate and high-risk factors of preoperative lower-limb deep venous thrombosis in patients with hip fracture / 中国组织工程研究

ABSTRACT

BACKGROUND: Patients with hip fracture are prone to be complicated with deep vein thrombosis of the lower extremity during the perioperative period, but there are few studies on the occurrence of deep vein thrombosis of the lower extremity in patients with hip fracture, especially the risk factors of deep vein thrombosis before surgery are not clear. OBJECTIVE: To explore the preoperative prevalence rate of lower-limb deep venous thrombosis in patients with hip fracture, and to investigate the high-risk factors of lower-limb deep venous thrombosis in patients with hip fracture. METHODS: A retrospective analysis was performed in 242 cases of hip fracture admitted to the Second Hospital of Anhui Medical University from January 2017 to December 2018, including 99 males and 143 females, with an average age of 69.1 years. There were 189 cases of femoral neck fracture and 53 cases of intertrochanteric fracture. All patients signed the formed consent. This study was approved by the Hospital Ethics Committee. All patients had no contraindications to anticoagulation. After admission, they were given prophylactic anti-coagulation with low molecular heparin. According to the results of color Doppler ultrasound examination of blood vessels in both lower limbs, the patients were divided into the lower-limb deep venous thrombosis group and the lower-limb non-deep venous thrombosis group (intraluminal filter placement before surgery for lower-limb deep venous thrombosis). Risk factors for thrombosis received univariate analysis, including age, sex, fracture type (femoral neck fractures and intertrochanteric fractures), time from injury to operation, laboratory examination (hematocrit, fibrinogen, D-dimer, and hemoglobin), and combination with chronic diseases (hypertension and diabetes). Multivariate logistic regression analysis was used to determine independent risk factors. RESULTS AND CONCLUSION: (1) Among 242 patients with hip fracture, 58 patients (24%) experienced lower-limb deep venous thrombosis. (2) There was no significant difference in gender, fracture type, D-dimer, fibrinogen, and combination with chronic diseases (hypertension and diabetes) between the lower-limb deep venous thrombosis group and the lower-limb non-deep venous thrombosis group (P > 0.05). The age, the time from injury to operation, and hemoglobin level were statistically significant between the two groups (P < 0.05). (3) Multivariate regression analysis showed that age ≥ 70 years old and time from injury to operation ≥ 5 days were independent risk factors for lower-limb deep venous thrombosis in patients with hip fracture. (4) It is indicated that patients with hip fracture are prone to lower-limb deep venous thrombosis even under the condition of prophylactic anticoagulant therapy. Among them, the elderly patients and the longer waiting time before surgery are the high-risk factors for thrombosis.