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红会医院创伤骨折患者深静脉血栓形成(DVT)危险因素的回顾性队列研究。

A Retrospective cohort study on the risk factors of deep vein thrombosis (DVT) for patients with traumatic fracture at Honghui Hospital.

机构信息

Lab for Bone Metabolism, Key Lab for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, China.

Research Center for Special Medicine and Health Systems Engineering, School of Life Sciences, Northwestern Polytechnical University, Xi'an, China.

出版信息

BMJ Open. 2019 Mar 3;9(3):e024247. doi: 10.1136/bmjopen-2018-024247.

Abstract

OBJECTIVE

To explore the risk factors of perioperative deep vein thrombosis (DVT) in patients with traumatic fracture after orthopaedic surgery and their potential diagnostic values in clinical.

DESIGN

Retrospective cohort study.

SETTING

Clinical Laboratory of Honghui Hospital, Xi'an JiaoTong University College of Medicine, Xi'an, Shaanxi, China.

MATERIALS AND METHODS

A retrospective cohort study was conducted with surgically treated fracture patients in Honghui Hospital from 1 May 2016 to 31 February 2017. test, independent sample t test and regression analysis were applied to examine the correlation between perioperative DVT and the factors of preoperative time, fracture sites, D-dimer value and chronic diseases (hypertension, diabetes and coronary disease).

RESULTS

462 patients were enrolled for analysis. The preoperative time of patients with DVT was significantly longer than that of non-DVT patients (7.14±5.51 vs 5.45±3.75) (<0.01). test showed the significant differences in the rate of DVT among patients with different fracture sites (<0.01). By the receiver-operating characteristic curve analysis, the cut-off value of preoperative D-dimer and postoperative D-dimer in diagnosing perioperative DVT was 4.01 µg/mL and 5.03 µg/mL, respectively. Area under the curve was 0.593 (95% CI 0.533 to 0.652) and 0.728 (95% CI 0.672 to 0.780), respectively. The sensitivity and specificity of preoperative D-dimer for DVT diagnosis were 71.30% and 44.83%, and as for postoperative D-dimer were 63.90% and 70.51%.

CONCLUSIONS

Fracture site was correlated to the incidence of DVT; prolonged preoperative time and increased D-dimer value were independent risk factors for DVT in patients with lower extremity traumatic fractures.

摘要

目的

探讨骨科创伤术后患者围手术期深静脉血栓形成(DVT)的危险因素及其在临床诊断中的潜在价值。

设计

回顾性队列研究。

地点

中国陕西西安交通大学医学部附属红会医院临床检验科。

材料与方法

回顾性队列研究,纳入 2016 年 5 月 1 日至 2017 年 2 月 28 日在红会医院接受手术治疗的骨折患者。采用单因素分析、检验、独立样本 t 检验和回归分析,分析术前时间、骨折部位、D-二聚体值和慢性病(高血压、糖尿病和冠心病)与围手术期 DVT 的相关性。

结果

共纳入 462 例患者进行分析。DVT 患者的术前时间明显长于非 DVT 患者(7.14±5.51 vs 5.45±3.75)(<0.01)。检验显示不同骨折部位 DVT 发生率存在显著差异(<0.01)。通过受试者工作特征曲线分析,术前 D-二聚体和术后 D-二聚体诊断围手术期 DVT 的截断值分别为 4.01 µg/mL 和 5.03 µg/mL。曲线下面积分别为 0.593(95% CI 0.533 至 0.652)和 0.728(95% CI 0.672 至 0.780)。术前 D-二聚体诊断 DVT 的敏感性和特异性分别为 71.30%和 44.83%,术后 D-二聚体分别为 63.90%和 70.51%。

结论

骨折部位与 DVT 的发生率有关;术前时间延长和 D-二聚体值升高是下肢创伤性骨折患者 DVT 的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e30a/6443064/034992b24906/bmjopen-2018-024247f01.jpg

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