Shibuya Naohiro, Frost Colby H, Campbell Jason D, Davis Matthew L, Jupiter Daniel C
Department of Surgery, Texas A&M Health Science Center College of Medicine, Temple, TX 76502, USA.
J Foot Ankle Surg. 2012 Jan-Feb;51(1):63-8. doi: 10.1053/j.jfas.2011.10.017.
The incidence of deep vein thrombosis (DVT) after foot and ankle surgery is generally believed to be low. However, little information is available regarding DVT as it specifically relates to foot and ankle trauma. The National Trauma Data Bank data set (2007 to 2009) was used to evaluate the incidence of thromboembolism in foot and ankle trauma. Also, the risk factors associated with the thromboembolic events were identified. Data regarding the demographics, comorbidities, procedures, trauma types, and complications, including DVT and pulmonary embolism (PE), were collected from the data set for analysis. The incidence of DVT and PE was 0.28% and 0.21%, respectively. The risk factors statistically significantly associated and clinically relevant for both DVT and PE in foot and ankle trauma were older age (DVT, odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01 to 1.03; PE, OR 1.02, 95% CI 1.01 to 1.03), obesity (DVT, OR 2.35, 95% CI 1.33 to 4.14; PE, OR 3.06, 95% CI 1.68 to 5.59), and higher injury severity score (DVT, OR 1.22, 95% CI 1.16 to 1.28; PE, OR 1.21, 95% CI 1.14 to 1.29). Owing to the low incidence, routine pharmacologic thromboprophylaxis might be contraindicated in foot and ankle trauma. Instead, careful, individualized assessment of the risk factors associated with DVT/PE is important.
一般认为，足踝手术后深静脉血栓形成（DVT）的发生率较低。然而，关于DVT与足踝创伤的具体关系，目前可用信息较少。利用国家创伤数据库数据集（2007年至2009年）评估足踝创伤中血栓栓塞的发生率。此外，还确定了与血栓栓塞事件相关的危险因素。从数据集中收集有关人口统计学、合并症、手术、创伤类型和并发症（包括DVT和肺栓塞（PE））的数据进行分析。DVT和PE的发生率分别为0.28%和0.21%。在足踝创伤中，与DVT和PE在统计学上显著相关且具有临床意义的危险因素包括年龄较大（DVT，比值比[OR]1.02，95%置信区间[CI]1.01至1.03；PE，OR 1.02，95%CI 1.01至1.03）、肥胖（DVT，OR 2.35，95%CI 1.33至4.14；PE，OR 3.06，95%CI 1.68至5.59）以及较高的损伤严重程度评分（DVT，OR 1.22，95%CI 1.16至1.28；PE，OR 1.21，95%CI 1.14至1.29）。由于发生率较低，足踝创伤中可能不适合常规药物性血栓预防。相反，仔细、个体化评估与DVT/PE相关的危险因素很重要。
