Knut Stavem1, Stein Arve Skjaker2, Henrik Hoel3, Markus Georg Naumann4, Ulf Sigurdsen5, Waleed Ghanima6, Stein Erik Utvåg7. 1. Institute of Clinical Medicine, University of Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Norway; Department of Pulmonary Medicine, Medical Division, Akershus University Hospital, Norway. Electronic address: knut.stavem@medisin.uio.no. 2. Section for Orthopaedic Emergency, Orthopaedic Department, Oslo University Hospital, Norway. 3. Department of Vascular Surgery, Oslo University Hospital, Aker, Norway. 4. Department of Orthopaedics, Østfold Hospital, Norway. 5. Department of Orthopaedics, Akershus University Hospital, Norway. 6. Institute of Clinical Medicine, University of Oslo, Norway; Department of Medicine, Østfold Hospital, Norway. 7. Institute of Clinical Medicine, University of Oslo, Norway; Department of Orthopaedics, Akershus University Hospital, Norway.
Abstract
BACKGROUND: We analyzed risk factors for venous thromboembolism (VTE) within 6 months after surgery for closed ankle fractures. METHODS: This was a case-control study based on data from chart review in a cohort of patients having open reduction and internal fixation (ORIF) for closed ankle fractures in two large general hospitals 2009-2011. Cases with symptomatic VTE (pulmonary embolism or deep venous thrombosis) were identified in the cohort, and additional cases of VTE were identified by computerized search of discharge diagnoses in the same hospitals in 2004-2008 and 2012-2016. In total, we identified 60 cases with VTE and compared with 240 randomly selected controls among 998 patients without VTE in the cohort. Risk factors were assessed using logistic regression analysis. RESULTS: Among cases, 27 (45%) had pulmonary embolism, 33 (55%) deep venous thrombosis. Those with VTE were older, had higher BMI, had more often a family history of VTE, and more often had antibiotic prophylaxis during surgery than controls. In multivariable logistic regression analysis age/10 (OR 25.75, 95%CI 3.52-188.44, p=0.001), (age/10)2 (OR 0.77, 95%CI 0.65-0.93, p=0.005), BMI (1.15 per kg/m2, 95%CI 1.07-1.24, p<0.001) and Charlson comorbidity index ≥2 vs.0 (OR 0.27, 95%CI 0.08-0.92, p=0.036) and 1 vs. 0 (OR 0.27, 95%CI 0.09-0.86, p=0.026) were associated with VTE within 6 months of surgery. CONCLUSIONS: The odds of symptomatic VTE within 6 months of ORIF increased with increasing age and BMI, but were lower with increasing comorbidity.
BACKGROUND: We analyzed risk factors for venous thromboembolism (VTE) within 6 months after surgery for closed ankle fractures. METHODS: This was a case-control study based on data from chart review in a cohort of patients having open reduction and internal fixation (ORIF) for closed ankle fractures in two large general hospitals 2009-2011. Cases with symptomatic VTE (pulmonary embolism or deep venous thrombosis) were identified in the cohort, and additional cases of VTE were identified by computerized search of discharge diagnoses in the same hospitals in 2004-2008 and 2012-2016. In total, we identified 60 cases with VTE and compared with 240 randomly selected controls among 998 patients without VTE in the cohort. Risk factors were assessed using logistic regression analysis. RESULTS: Among cases, 27 (45%) had pulmonary embolism, 33 (55%) deep venous thrombosis. Those with VTE were older, had higher BMI, had more often a family history of VTE, and more often had antibiotic prophylaxis during surgery than controls. In multivariable logistic regression analysis age/10 (OR 25.75, 95%CI 3.52-188.44, p=0.001), (age/10)2 (OR 0.77, 95%CI 0.65-0.93, p=0.005), BMI (1.15 per kg/m2, 95%CI 1.07-1.24, p<0.001) and Charlson comorbidity index ≥2 vs.0 (OR 0.27, 95%CI 0.08-0.92, p=0.036) and 1 vs. 0 (OR 0.27, 95%CI 0.09-0.86, p=0.026) were associated with VTE within 6 months of surgery. CONCLUSIONS: The odds of symptomatic VTE within 6 months of ORIF increased with increasing age and BMI, but were lower with increasing comorbidity.
Authors: Thien Trung Tran; Haraldur Bjarnason; Jennifer McDonald; Brian Goss; Brian Kim; Damon E Houghton; Knut Stavem; Nils Einar Kløw Journal: Eur J Radiol Open Date: 2020-12-10