Park Jin Sup, Jang Jae Hoon, Park Ki Young, Moon Nam Hoon
Division of Cardiology, Pusan National University Hospital, Busan, Republic of Korea.
Trauma Center, Pusan National University Hospital, Busan, Republic of Korea.
Injury. 2018 Jun;49(6):1155-1161. doi: 10.1016/j.injury.2018.04.026. Epub 2018 Apr 24.
The purpose of this study was to identify the incidence of preoperative venous thromboembolism (VTE), and determine if high energy hip fracture affects preoperative VTE occurrence.
Three-hundred nine patients (244 low and 61 high energy injuries) treated between March 2015 and March 2017 were included in this study. Indirect multidetector computed tomographic venography for the detection of preoperative VTE was performed at admission. The incidence of preoperative VTE was compared between high and low energy injury hip fractures. Logistic regression analysis was used to identify independent risk factors for preoperative VTE.
The overall incidence of preoperative VTE was 18.4% (56 of 305 patients). Preoperative VTE was identified in 17 (27.9%) and 39 (16.0%) patients in the high and low energy injury groups, respectively (p = 0.034). Multivariate logistic regression analysis showed that high energy injury, history of VTE, and myeloproliferative disease were significant predictive factors of preoperative VTE (OR = 2.451; 95% CI = 1.227-4.896, OR = 11.174; 95% CI = 3.500-35.673, OR = 6.936; 95% CI = 1.641-29.321, respectively) CONCLUSION: Because high energy hip fracture is significantly associated with preoperative VTE occurrence, preoperative evaluation and proper thromboprophylaxis should be performed for patients with a high-energy hip fracture.
本研究旨在确定术前静脉血栓栓塞症(VTE)的发生率,并确定高能髋部骨折是否会影响术前VTE的发生。
本研究纳入了2015年3月至2017年3月期间治疗的309例患者(244例低能量损伤和61例高能量损伤)。入院时进行间接多排螺旋CT静脉造影以检测术前VTE。比较高能和低能损伤髋部骨折术前VTE的发生率。采用逻辑回归分析确定术前VTE的独立危险因素。
术前VTE的总体发生率为18.4%(305例患者中的56例)。高能量损伤组和低能量损伤组分别有17例(27.9%)和39例(16.0%)患者被诊断为术前VTE(p = 0.034)。多因素逻辑回归分析显示,高能损伤、VTE病史和骨髓增殖性疾病是术前VTE的重要预测因素(OR分别为2.451;95%CI = 1.227 - 4.896,OR = 11.174;95%CI = 3.500 - 35.673,OR = 6.936;95%CI = 1.641 - 29.321)。结论:由于高能髋部骨折与术前VTE的发生显著相关,因此应对高能髋部骨折患者进行术前评估并采取适当的血栓预防措施。