Zhuang Qianzheng, He Qifei, Aikebaier Aobulikasimu, Chen Wenshi, Liu Jianquan, Wang Daping
Hand and Foot Surgery Department, The First Hospital Affiliated to Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518000, China.
Department of Bone Joint and Musculoskeletal Tumor, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518000, China.
J Pers Med. 2023 Jan 30;13(2):257. doi: 10.3390/jpm13020257.
Calf muscle venous thrombosis (CMVT) is among the most important medical complications after hip surgery. CMVT has been known for many years, but many opinions about the incidence and risk factors of CMVT are still controversial. The objective of this retrospective study was to investigate the incidence and associated risk factors of postoperative CMVT in patients with hip fractures.
Patients with hip fractures from January 2020 to April 2022 ( = 320) at Shenzhen Second People's Hospital were recruited in this study. The personal characteristics and clinical data of CMVT and no-CMVT patients were compared and analyzed. Binary logistic regression analyses were performed to identify potential risk factors of CMVT in patients with hip fractures. Finally we performed a receiver operating characteristic (ROC) curve analysis to compare the diagnostic values of different variables.
The overall incidence of new-onset CMVT in patients with hip fractures was 18.75% (60 of 320). Among the 60 CMVT patients, 70% (42 of 60) were diagnosed with femoral neck fractures, 28.3% (17 of 60) with intertrochanteric fractures, and 1.7% (1 of 60) with subtrochanteric fractures. No pulmonary embolism (PE) occurred. High preoperative D-dimer (OR = 1.002, 95%CI 0.97-1.03), sex (OR = 1.22, 95%CI 0.51-2.96), the caprini score (OR = 2.32, 95%CI 1.05-5.16) and the waterlow score (OR = 1.077, 95%CI 0.35-3.36) significantly increased the risk of developing postoperative new-onset CMVT.
CMVT has become a common clinical disease, and its harm should not be underestimated. Our study found that D-dimer, sex, the caprini score and the waterlow score were independent risk factors for postoperative CMVT. According to our clinical work, we should pay attention to identifying the risk factors of CMVT formation and targeted intervention measures to prevent new-onset CMVT.
小腿肌肉静脉血栓形成（CMVT）是髋关节手术后最重要的医学并发症之一。CMVT已被认识多年，但关于CMVT的发病率和危险因素仍存在许多争议。本回顾性研究的目的是调查髋部骨折患者术后CMVT的发病率及相关危险因素。
本研究纳入了2020年1月至2022年4月在深圳市第二人民医院就诊的髋部骨折患者（n = 320）。比较并分析了发生CMVT和未发生CMVT患者的个人特征和临床资料。进行二元逻辑回归分析以确定髋部骨折患者发生CMVT的潜在危险因素。最后，我们进行了受试者工作特征（ROC）曲线分析，以比较不同变量的诊断价值。
髋部骨折患者中新发CMVT的总体发病率为18.75%（320例中的60例）。在60例CMVT患者中，70%（60例中的42例）被诊断为股骨颈骨折，28.3%（60例中的17例）为转子间骨折，1.7%（60例中的1例）为转子下骨折。未发生肺栓塞（PE）。术前D-二聚体升高（OR = 1.002，95%CI 0.97 - 1.03）、性别（OR = 1.22，95%CI 0.51 - 2.96）、Caprini评分（OR = 2.32，95%CI 1.05 - 5.16）和Waterlow评分（OR = 1.077，95%CI 0.35 - 3.36）显著增加了术后新发CMVT发生的风险。
CMVT已成为一种常见的临床疾病，其危害不容小觑。我们的研究发现，D-二聚体、性别、Caprini评分和Waterlow评分是术后CMVT的独立危险因素。根据我们的临床工作，应注意识别CMVT形成的危险因素并采取针对性干预措施，以预防新发CMVT。
