Wei Chen1,2,3, Yingze Zhang1,2,3,4,5, Kuo Zhao1,2,3, Zhongzheng Wang1,2,3, Siyu Tian1,2,3, Zhiyong Hou6,7,8,9. 1. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, Hebei, People's Republic of China. 2. Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China. 3. Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China. 4. NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Hebei, People's Republic of China. 5. Chinese Academy of Engineering, Beijing, 10088, People's Republic of China. 6. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, Hebei, People's Republic of China. drzyhou@gmail.com. 7. Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China. drzyhou@gmail.com. 8. Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China. drzyhou@gmail.com. 9. NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Hebei, People's Republic of China. drzyhou@gmail.com.
Abstract
PURPOSE: The purpose of this prospective study was to investigate the pre-operative incidence of and risk factors for deep venous thrombosis (DVT) in geriatric intertrochanteric fractures to help facilitate the peri-operative management of them. MATERIALS AND METHODS: Data of 1515 geriatric intertrochanteric fracture patients were extracted from a prospective intertrochanteric fractures database according to the inclusion criteria and exclusion criteria. The demographics, fracture characteristics, and pre-operative laboratory indicators of patients were evaluated statistically. RESULTS: The incidence of pre-operative DVT was 10.2% (155 in 1360 patients) in the present study. The rates of proximal DVT, distal DVT, and mixed DVT were 18.1% (28 patients), 56.8% (88 patients), and 25.2% (39 patients), respectively. The percentages of DVT developing in the affected limb, uninjured limb, and bilateral limbs were 74.2% (115 in 55 patients), 16.8% (26 in 155 patients), and 9% (14 in 155 patients), respectively. After the multivariable analysis, the time from injury to surgery (TIS) > 4 days [odds ratio (OR) = 1.870, p = 0.001], the number of comorbidities > 2 (OR = 2.124, p = 0.014), and albumin (ALB) < 35 g/L (OR = 1.516, p = 0.043), etc. were significantly associated with the development of preoperative DVT in geriatric intertrochanteric fracture patients. CONCLUSIONS: Although routine anticoagulant therapy was used to prevent the formation of DVT, the incidence of which was still high. Therefore, pre-operative ultrasound of both lower extremities was advised for pre-operatively, especially for patients with delayed surgery, hypoproteinemia, three or more comorbidities, and a D-dimer level > 1.59 mg/L.
PURPOSE: The purpose of this prospective study was to investigate the pre-operative incidence of and risk factors for deep venous thrombosis (DVT) in geriatric intertrochanteric fractures to help facilitate the peri-operative management of them. MATERIALS AND METHODS: Data of 1515 geriatric intertrochanteric fracture patients were extracted from a prospective intertrochanteric fractures database according to the inclusion criteria and exclusion criteria. The demographics, fracture characteristics, and pre-operative laboratory indicators of patients were evaluated statistically. RESULTS: The incidence of pre-operative DVT was 10.2% (155 in 1360 patients) in the present study. The rates of proximal DVT, distal DVT, and mixed DVT were 18.1% (28 patients), 56.8% (88 patients), and 25.2% (39 patients), respectively. The percentages of DVT developing in the affected limb, uninjured limb, and bilateral limbs were 74.2% (115 in 55 patients), 16.8% (26 in 155 patients), and 9% (14 in 155 patients), respectively. After the multivariable analysis, the time from injury to surgery (TIS) > 4 days [odds ratio (OR) = 1.870, p = 0.001], the number of comorbidities > 2 (OR = 2.124, p = 0.014), and albumin (ALB) < 35 g/L (OR = 1.516, p = 0.043), etc. were significantly associated with the development of preoperative DVT in geriatric intertrochanteric fracture patients. CONCLUSIONS: Although routine anticoagulant therapy was used to prevent the formation of DVT, the incidence of which was still high. Therefore, pre-operative ultrasound of both lower extremities was advised for pre-operatively, especially for patients with delayed surgery, hypoproteinemia, three or more comorbidities, and a D-dimer level > 1.59 mg/L.
Authors: Won Chul Shin; Seung Hun Woo; Seung-Jun Lee; Jung Sub Lee; Choongrak Kim; Kuen Tak Suh Journal: J Bone Joint Surg Am Date: 2016-12-21 Impact factor: 5.284
Authors: G E Raskob; P Angchaisuksiri; A N Blanco; H Buller; A Gallus; B J Hunt; E M Hylek; A Kakkar; S V Konstantinides; M McCumber; Y Ozaki; A Wendelboe; J I Weitz Journal: Arterioscler Thromb Vasc Biol Date: 2014-11 Impact factor: 8.311