Cho Young-Ho, Byun Young-Soo, Jeong Dae-Geun, Han In-Ho, Park Young-Bo
Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, Korea.
Clin Orthop Surg. 2015 Sep;7(3):298-302. doi: 10.4055/cios.2015.7.3.298. Epub 2015 Aug 13.
The purpose of the current study was to investigate the incidence of preoperative deep vein thrombosis (DVT) after hip fractures in Korea.
In this prospective study, we enrolled 152 Korean geriatric patients who had suffered hip fractures due to a simple fall and were hospitalized between January 2013 and December 2013. There were 52 male and 100 female patients, and their mean age was 78.2 years. There were 96 trochanteric fractures and 56 femoral neck fractures. All patients were examined for DVT: 26 by ultrasonography and 126 by computed tomography venography. The patients having DVT underwent inferior vena cava filter insertion before the surgical intervention.
Preoperatively, none of the patients had any signs or symptoms of DVT; however, 4 patients were identified as having asymptomatic DVT. The overall incidence of DVT was 2.6% (4/152). The mean time to arrival at emergency room after injury was 32.6 hours. Mean time elapsed to undergo surgery after hospitalization was 24.9 hours. The average time to hospitalization after injury was 237 hours for patients with DVT versus 27.5 hours for patients without DVT. DVT developed within 72 hours in two of the 137 patients (1.4%) and after 72 hours in two of the remaining 15 patients (13.3%) hospitalized.
While the preoperative incidence of DVT after hip fractures was relatively low (2.6%) in the Korean geriatric population, we confirmed that getting no treatment within 72 hours after injury increased the incidence of DVT. Thus, we conclude from this study that a workup for DVT should be considered in cases where admission or surgery has been delayed for more than 72 hours after injury.
本研究旨在调查韩国髋部骨折患者术前深静脉血栓形成（DVT）的发生率。
在这项前瞻性研究中，我们纳入了152例因单纯跌倒而发生髋部骨折并于2013年1月至2013年12月期间住院的韩国老年患者。其中男性52例，女性100例，平均年龄为78.2岁。有96例转子间骨折和56例股骨颈骨折。所有患者均接受DVT检查：26例通过超声检查，126例通过计算机断层扫描静脉造影检查。患有DVT的患者在手术干预前进行下腔静脉滤器置入。
术前，所有患者均无DVT的任何体征或症状；然而，4例患者被确定为无症状DVT。DVT的总体发生率为2.6%（4/152）。受伤后到达急诊室的平均时间为32.6小时。住院后接受手术的平均时间为24.9小时。发生DVT的患者受伤后住院的平均时间为237小时，而未发生DVT的患者为27.5小时。137例患者中有2例（1.4%）在72小时内发生DVT，其余15例住院患者中有2例（13.3%）在72小时后发生DVT。
虽然韩国老年人群中髋部骨折后术前DVT的发生率相对较低（2.6%），但我们证实受伤后72小时内未接受治疗会增加DVT的发生率。因此，我们从本研究得出结论，对于受伤后入院或手术延迟超过72小时的病例，应考虑进行DVT检查。
