Department of Orthopedic Trauma, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Beilin District, Xi'an, Shaanxi, China.
Clin Interv Aging. 2018 Apr 18;13:681-689. doi: 10.2147/CIA.S161191. eCollection 2018.
To investigate the incidences of deep vein thrombosis (DVT) before and after operation in inpatients with hip fractures in both lower extremities.
We collected the clinical data of 463 patients with lower extremities fractures who presented at Xi'an Honghui Hospital between July 1, 2014, and October 31, 2016 and met all the inclusion criteria. Doppler ultrasonography was used to diagnose DVT. The patients were examined preoperatively and postoperatively and divided into the thrombosis and non-thrombosis group according to the ultrasonographic findings. We divided the DVT cases into central, peripheral, and mixed thromboses.
The incidence of preoperative DVT was 34.98%, and the prevalence of DVT on the uninjured side was 13.60%. This composition ratio increased to 57.23% postoperatively, and the prevalence of DVT on the uninjured side was 25.05%. Age (odds ratio [OR], 1.03; 95% CI: 1.01-1.04; =0.002), venous thrombosis at admission (OR, 4.05; 95% CI, 2.30-7.13; =0.000), and the days between the fracture and the operation (OR, 1.10; 95% CI, 1.02-1.20; =0.020) were the independent risk factors of preoperative DVT. Coronary heart disease (OR, 1.85; 95% CI: 1.18-2.89; =0.007), venous thrombosis at admission (OR, 22.35; 95% CI: 6.78-73.60; =0.000), days between fracture and operation (OR, 1.06; 95% CI: 1.01-1.11; =0.021), and blood loss (OR, 1.002; 95% CI: 1.000-1.003; =0.014) were independent risk factors of postoperative DVT.
The actual incidence of DVT after hip fracture may be underestimated. The incidences of preoperative and postoperative DVTs and the incidence of DVT on the uninjured limb were high.
调查双侧下肢髋部骨折住院患者手术前后深静脉血栓(DVT)的发生率。
我们收集了 2014 年 7 月 1 日至 2016 年 10 月 31 日期间在西安红会医院就诊且符合所有纳入标准的 463 例下肢骨折患者的临床资料。采用多普勒超声诊断 DVT。患者术前及术后接受检查,并根据超声检查结果分为血栓组和非血栓组。我们将 DVT 病例分为中央型、外周型和混合型。
术前 DVT 发生率为 34.98%,健侧 DVT 发生率为 13.60%。这一比例在术后增加至 57.23%,健侧 DVT 发生率为 25.05%。年龄(比值比 [OR],1.03;95%可信区间:1.01-1.04;=0.002)、入院时静脉血栓(OR,4.05;95%可信区间,2.30-7.13;=0.000)和骨折至手术的时间(OR,1.10;95%可信区间,1.02-1.20;=0.020)是术前 DVT 的独立危险因素。冠心病(OR,1.85;95%可信区间:1.18-2.89;=0.007)、入院时静脉血栓(OR,22.35;95%可信区间:6.78-73.60;=0.000)、骨折至手术的时间(OR,1.06;95%可信区间,1.01-1.11;=0.021)和出血量(OR,1.002;95%可信区间,1.000-1.003;=0.014)是术后 DVT 的独立危险因素。
髋部骨折后 DVT 的实际发生率可能被低估。术前、术后 DVT 发生率及健侧肢体 DVT 发生率均较高。