髋关节骨折患者术前深静脉血栓形成的危险因素：荟萃分析。
Risk factors for preoperative deep venous thrombosis in hip fracture patients: a meta-analysis.
机构信息
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, People's Republic of China.
出版信息
J Orthop Traumatol. 2022 Apr 7;23(1):19. doi: 10.1186/s10195-022-00639-6.
STUDY DESIGN
A meta-analysis.
BACKGROUND
Hip fracture (HF), as common geriatric fracture, is related to increased disability and mortality. Preoperative deep vein thrombosis (DVT) is one of the most common complications in patients with hip fractures, affecting 8-34.9% of hip fracture patients. The study aimed to assess the risk factors of preoperative DVT after hip fractures by meta-analysis.
METHODS
An extensive search of the literature was performed in the English databases of PubMed, Embase, and the Cochrane Library; and the Chinese databases of CNKI and WAN FANG. We collected possible predictors of preoperative DVT from included studies, and data analysis was conducted with RevMan 5.3 and STATA 12.0.
RESULTS
A total of 26 English articles were included, and the rate of DVT was 16.6% (1627 of 9823 patients) in our study. Our findings showed that advanced age [p = 0.0003, OR = 0.13 95% CI (0.06, 0.21)], female patients [p = 0.0009, OR = 0.82 95% CI (0.72, 0.92)], high-energy injury [p = 0.009, OR = 0.58 95% CI (0.38, 0.87)], prolonged time from injury to admission [p < 0.00001, OR = 0.54 95% CI (0.44, 0.65)], prolonged time from injury to surgery [p < 0.00001, OR = 2.06, 95% CI (1.40, 2.72)], hemoglobin [p < 0.00001, OR = - 0.32 95% CI (- 0.43, - 0.21)], coronary heart disease [p = 0.006, OR = 1.25 95% CI (1.07, 1.47)], dementia [p = 0.02, OR = 1.72 95% CI (1.1, 2.67)], liver and kidney diseases [p = 0.02, OR = 1.91 95% CI (1.12, 3.25)], pulmonary disease [p = 0.02, OR = 1.55 95% CI (1.07, 2.23)], smoking [p = 0.007, OR = 1.45 95% CI (1.11, 1.89)], fibrinogen [p = 0.0005, OR = 0.20 95% CI (0.09, 0.32)], anti-platelet drug [p = 0.01, OR = 0.51 95% CI (0.30, 0.85)], C-reactive protein [p = 0.02, OR = 5.95 95% CI (1.04, 10.85)], < 35 g/l albumin [p = 0.006, OR = 1.42 95% CI (1.1, 1.82)], and thrombosis history [p < 0.00001, OR = 5.28 95% CI (2.85, 9.78)] were risk factors for preoperative DVT.
CONCLUSIONS
Many factors, including advanced age, female patients, high-energy injury, prolonged time from injury to admission, prolonged time from injury to surgery, patients with a history of coronary heart disease, dementia, liver and kidney diseases, pulmonary disease, smoking, and thrombosis, fibrinogen, C-reactive protein, and < 35 g/l albumin, were found to be associated with preoperative DVT. Our findings suggested that the patient with above characteristics might have preoperative DVT.
LEVEL OF EVIDENCE
Level III.
研究设计
荟萃分析。
背景
髋部骨折（HF）作为常见的老年骨折，与残疾和死亡率增加有关。术前深静脉血栓形成（DVT）是髋部骨折患者最常见的并发症之一，影响 8-34.9%的髋部骨折患者。本研究旨在通过荟萃分析评估髋部骨折后术前 DVT 的危险因素。
方法
在 PubMed、Embase 和 Cochrane 图书馆的英文数据库以及 CNKI 和万方的中文数据库中进行了广泛的文献搜索。我们从纳入的研究中收集了术前 DVT 的可能预测因素，并使用 RevMan 5.3 和 STATA 12.0 进行数据分析。
结果
共纳入 26 篇英文文献，本研究中 DVT 的发生率为 16.6%（9823 例患者中有 1627 例）。我们的研究结果表明，高龄[P=0.0003，OR=0.13，95%CI（0.06，0.21）]、女性患者[P=0.0009，OR=0.82，95%CI（0.72，0.92）]、高能损伤[P=0.009，OR=0.58，95%CI（0.38，0.87）]、从受伤到入院的时间延长[P<0.00001，OR=0.54，95%CI（0.44，0.65）]、从受伤到手术的时间延长[P<0.00001，OR=2.06，95%CI（1.40，2.72）]、血红蛋白[P<0.00001，OR=-0.32，95%CI（-0.43，-0.21）]、冠心病[P=0.006，OR=1.25，95%CI（1.07，1.47）]、痴呆[P=0.02，OR=1.72，95%CI（1.1，2.67）]、肝肾功能疾病[P=0.02，OR=1.91，95%CI（1.12，3.25）]、肺部疾病[P=0.02，OR=1.55，95%CI（1.07，2.23）]、吸烟[P=0.007，OR=1.45，95%CI（1.11，1.89）]、纤维蛋白原[P=0.0005，OR=0.20，95%CI（0.09，0.32）]、抗血小板药物[P=0.01，OR=0.51，95%CI（0.30，0.85）]、C 反应蛋白[P=0.02，OR=5.95，95%CI（1.04，10.85）]、白蛋白<35 g/l[P=0.006，OR=1.42，95%CI（1.1，1.82）]和血栓病史[P<0.00001，OR=5.28，95%CI（2.85，9.78）]是术前 DVT 的危险因素。
结论
许多因素，包括高龄、女性患者、高能损伤、从受伤到入院的时间延长、从受伤到手术的时间延长、冠心病、痴呆、肝肾功能疾病、肺部疾病、吸烟和血栓形成、纤维蛋白原、C 反应蛋白和白蛋白<35 g/l，与术前 DVT 相关。我们的研究结果表明，具有上述特征的患者可能存在术前 DVT。
证据水平
III 级。
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