Hongyu Meng1, Yanbin Zhu2, Junzhe Zhang3, Junyong Li4, Kuo Zhao5, Yingze Zhang6, Wei Chen7. 1. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address: doctor.meng@gmail.com. 2. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address: zhuyanbin111@126.com. 3. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address: junzhezhang_MD@126.com. 4. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address: 175546860@qq.com. 5. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address: surzhao@163.com. 6. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Chinese Academy of Engineering, Beijing 100088, PR China. Electronic address: drzhang2013@126.com. 7. Department of orthopaedic surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, PR China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, PR China; Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, PR China. Electronic address: surgeonchenwei@126.com.
Abstract
BACKGROUNDS: Deep vein thrombosis (DVT) occurring during the preoperative waiting period may affect the prognosis of traumatic patients, but there still lack of relevant data. This study aimed to address the preoperative DVT in isolated calcaneal fractures. METHODS: Patients who presented with isolated calcaneal fracture and received preoperative Duplex ultrasound scanning of bilateral lower extremities for detection of DVT between October and December 2018 were eligible for inclusion. Relevant data were prospectively collected, including demographics, comorbidities, lifestyles, injury, and laboratory biomarkers at admission. Univariate analyses were used to compare the difference of each variable between patients with and without DVT. Multivariate logistics regression analysis was used to identify the independent risk factors for DVT. RESULTS: Totally, 770 patients met the criteria and were included, and 24 (3.1%) had preoperative DVT diagnosed at mean of 5.3 days after injury, all of which were asymptomatic. Among patients with DVTs, 36 thrombi were found and 29 (80.6%) were in distal veins. Eight patients had DVTs in multiple veins, but no patients had bilateral DVTs. The multivariate analyses showed older age (≥58 vs <58 years, OR = 3.84), delay from injury to DUS (in each day, OR = 1.23) and elevated plasma D-dimer level (≥1.79 vs <1.79 mg/L, OR = 2.53) were independent risk factors associated with DVT. CONCLUSIONS: Due to low prevalence of DVT in isolated fracture, routine throboprophylaxis is not recommended. However, emphasis should be given in older patients with delay to admission and elevated plasma D-dimer level for targeted detection of DVT and rapid therapeutic intervention.
BACKGROUNDS: Deep vein thrombosis (DVT) occurring during the preoperative waiting period may affect the prognosis of traumatic patients, but there still lack of relevant data. This study aimed to address the preoperative DVT in isolated calcaneal fractures. METHODS:Patients who presented with isolated calcaneal fracture and received preoperative Duplex ultrasound scanning of bilateral lower extremities for detection of DVT between October and December 2018 were eligible for inclusion. Relevant data were prospectively collected, including demographics, comorbidities, lifestyles, injury, and laboratory biomarkers at admission. Univariate analyses were used to compare the difference of each variable between patients with and without DVT. Multivariate logistics regression analysis was used to identify the independent risk factors for DVT. RESULTS: Totally, 770 patients met the criteria and were included, and 24 (3.1%) had preoperative DVT diagnosed at mean of 5.3 days after injury, all of which were asymptomatic. Among patients with DVTs, 36 thrombi were found and 29 (80.6%) were in distal veins. Eight patients had DVTs in multiple veins, but no patients had bilateral DVTs. The multivariate analyses showed older age (≥58 vs <58 years, OR = 3.84), delay from injury to DUS (in each day, OR = 1.23) and elevated plasma D-dimer level (≥1.79 vs <1.79 mg/L, OR = 2.53) were independent risk factors associated with DVT. CONCLUSIONS: Due to low prevalence of DVT in isolated fracture, routine throboprophylaxis is not recommended. However, emphasis should be given in older patients with delay to admission and elevated plasma D-dimer level for targeted detection of DVT and rapid therapeutic intervention.