Hebei Orthopedic Clinical Research Center, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.
Sci Rep. 2021 Jan 28;11(1):2441. doi: 10.1038/s41598-021-82147-x.
The aim of this study was to investigate the presence of preoperative DVT following spinal fracture and the association between the presence of DVT and risk factors. Ultrasonography and blood analyses were performed preoperatively in patients diagnosed with spinal fracture between October 2014 and December 2018. Univariate analyses were performed on the data of demographics, comorbidities, location of injury, spinal cord injury (SCI) grading and laboratory biomarkers. The receiver operating characteristic (ROC) curve analysis was employed to obtain the optimal D-dimer cut-off value for diagnosis. In total, 2432 patients with spinal fractures were included, among whom 108 (4.4%) patients had preoperative DVTs. The average interval between fracture and initial diagnosis of DVT was 4.7 days (median, 2 days), ranging from 0 to 20 days; 78 (72.2%) were diagnosed within 7 days after injury and 67 (62.0%) within 3 days; 19 (17.5%) patients had proximal vein involved and 89 (82.4%) presented in distal veins. Multivariate logistic regression suggested six risk factors independently correlated to DVT, including delay to DUS (in each day) (odds ratio [OR] = 1.11), ASA class III-IV (OR = 2.36), ASIA grade (A/B) (OR = 2.36), ALB < 3.5 g/dL (OR = 2.08), HDL-C < 1.1 mmol/L (OR = 1.68) and D-Dimer > 1.08 µg/ml (OR = 2.49).
本研究旨在探讨脊柱骨折患者术前是否存在深静脉血栓形成（DVT），以及 DVT 的存在与危险因素之间的关系。2014 年 10 月至 2018 年 12 月期间，对诊断为脊柱骨折的患者进行术前超声检查和血液分析。对患者的人口统计学、合并症、损伤部位、脊髓损伤（SCI）分级和实验室生物标志物数据进行单因素分析。采用受试者工作特征（ROC）曲线分析获得诊断的最佳 D-二聚体截断值。共纳入 2432 例脊柱骨折患者，其中 108 例（4.4%）患者术前存在 DVT。骨折与 DVT 初始诊断之间的平均间隔为 4.7 天（中位数 2 天），范围为 0 至 20 天；78 例（72.2%）在损伤后 7 天内诊断，67 例（62.0%）在 3 天内诊断；19 例（17.5%）患者累及近端静脉，89 例（82.4%）累及远端静脉。多因素 logistic 回归分析提示 6 个独立的危险因素与 DVT 相关，包括超声检查延迟（每天）（比值比[OR] = 1.11）、ASA 分级 III-IV（OR = 2.36）、ASIA 分级（A/B）（OR = 2.36）、ALB < 3.5 g/dL（OR = 2.08）、HDL-C < 1.1 mmol/L（OR = 1.68）和 D-二聚体 > 1.08 µg/ml（OR = 2.49）。
