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转子间骨折手术后新发深静脉血栓形成的发生率和危险因素。

Incidence of and risk factors for new-onset deep venous thrombosis after intertrochanteric fracture surgery.

机构信息

Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.

Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

Sci Rep. 2021 Aug 27;11(1):17319. doi: 10.1038/s41598-021-96937-w.

Abstract

This study aimed to investigate the incidence of and risk factors for postoperative new-onset deep venous thrombosis (PNO-DVT) following intertrochanteric fracture surgery. Information on 1672 patients who underwent intertrochanteric fracture surgery at our hospital between January 2016 and December 2019 was extracted from a prospective hip fracture database. Demographic information, surgical data, and preoperative laboratory indices were analysed. Receiver operating characteristic curve analysis, univariate analyses and binary logistic regression analyses were performed. The incidences of postoperative deep venous thrombosis (DVT) and PNO-DVT in inpatients after intertrochanteric fracture surgery were 11.5% (202 of 1751 patients) and 7.4% (123 of 1672 patients), respectively. PNO-DVT accounted for 60.9% of postoperative DVT. Additionally, there were 20 cases of central thrombosis (16.3%), 82 cases of peripheral thrombosis (66.7%), and 21 cases of mixed thrombosis (17.1%). In addition, 82.1% of PNO-DVTs were diagnosed within 8 days after surgery. The multivariate analysis revealed that age > 70 years, duration of surgery (> 197 min), type of anaesthesia (general), and comorbidities (≥ 3) were independent risk factors for the development of PNO-DVT after intertrochanteric fracture surgery. This study demonstrated a high incidence of PNO-DVT in inpatients after intertrochanteric fracture surgery. Therefore, postoperative examination for DVT should be routinely conducted for patients.

摘要

本研究旨在探讨转子间骨折手术后新发深静脉血栓形成(PNO-DVT)的发生率和危险因素。从我院 2016 年 1 月至 2019 年 12 月期间接受转子间骨折手术的 1672 名患者的前瞻性髋部骨折数据库中提取信息。分析人口统计学信息、手术数据和术前实验室指标。进行了受试者工作特征曲线分析、单因素分析和二元逻辑回归分析。转子间骨折手术后住院患者术后深静脉血栓形成(DVT)和 PNO-DVT 的发生率分别为 11.5%(202/1751 例)和 7.4%(123/1672 例)。PNO-DVT 占术后 DVT 的 60.9%。此外,还有 20 例中央血栓形成(16.3%)、82 例周围血栓形成(66.7%)和 21 例混合血栓形成(17.1%)。此外,82.1%的 PNO-DVT 是在手术后 8 天内诊断出来的。多因素分析显示,年龄>70 岁、手术时间(>197 分钟)、麻醉类型(全身)和合并症(≥3 种)是转子间骨折手术后发生 PNO-DVT 的独立危险因素。本研究表明,转子间骨折手术后住院患者的 PNO-DVT 发生率较高。因此,应常规对 DVT 术后患者进行检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dc7/8397722/93868e400ff6/41598_2021_96937_Fig1_HTML.jpg

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