Fan Jixing, Zhou Fang, Xu Xiangyu, Zhang Zhishan, Tian Yun, Ji Hongquan, Guo Yan, Lv Yang, Yang Zhongwei, Hou Guojin
Department of Orthopedics, Peking University Third Hospital, No. 49, North Garden Rd., Haidian District, Beijing, 100191, China.
BMC Musculoskelet Disord. 2021 Apr 2;22(1):328. doi: 10.1186/s12891-021-04196-7.
Limited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures.
This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients' clinical data were collected. Univariate analysis and stepwise backward multivariate logistic regression were used to identify the risk factors contributing to the occurrence of DVT.
The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). The mean time from injury to admission was 2.1 days in the total population, 2.96 and 1.87 days in patients with and without DVT. Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, lower Hb value, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P < 0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, lower Hb, diabetes and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT.
A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, surgeons should be aware of the high prevalence of DVT for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.
关于老年转子间骨折患者入院时深静脉血栓形成（DVT）患病率的研究有限。本研究旨在评估老年转子间骨折患者入院前DVT的危险因素及患病率。
本回顾性研究纳入了2010年1月1日至2019年12月31日期间符合本研究条件的788例老年转子间骨折患者。入院时采用彩色多普勒超声检查DVT。收集所有患者的临床资料。采用单因素分析和逐步向后多因素logistic回归分析确定导致DVT发生的危险因素。
转子间骨折患者入院前DVT的总体患病率为20.81%（788例患者中的164例）。总体人群从受伤到入院的平均时间为2.1天，有DVT和无DVT的患者分别为2.96天和1.87天。单因素分析显示，受伤至入院时间较长、高能损伤、血红蛋白值较低、体重指数较高、糖尿病、慢性阻塞性肺疾病（COPD）、心房颤动、痴呆、静脉曲张、年龄调整后的CCI较高、ASA分级较高和A3型转子间骨折患者发生DVT的风险显著升高（P<0.05）。多因素logistic回归分析显示，受伤至入院时间较长、高能创伤、COPD、血红蛋白较低、糖尿病和A3型转子间骨折是入院前DVT的独立危险因素。
中国老年转子间骨折患者入院前DVT患病率较高。因此，外科医生应意识到老年转子间骨折患者DVT的高患病率，以预防术中及术后肺栓塞和其他致命并发症。
