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下肢长骨骨折患者术前深静脉血栓形成的患病率:系统评价和荟萃分析。

Prevalence of preoperative deep vein thrombosis in long bone fractures of lower limbs: a systematic review and meta-analysis.

机构信息

Beijing Jishuitan Hospital, The Fourth Clinical Medical College, Peking University Health Science Center, Beijing, China.

Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing, China.

出版信息

J Orthop Traumatol. 2023 May 8;24(1):19. doi: 10.1186/s10195-023-00699-2.

Abstract

BACKGROUND

There is a paucity of data regarding the prevalence of preoperative deep vein thrombosis (DVT) in patients with long bone (including femur, tibia and fibula) fractures of the lower limbs. We performed a meta-analysis to address the issue.

METHODS

Electronic databases, including PubMed, EMBASE, the Web of Science, the Cochrane Library, the VIP database, CNKI, and the Wanfang database, were systematic searched for original articles that reported the prevalence of preoperative DVT in long bone fractures of the lower limbs from January 2016 to September 2021. The prevalence of preoperative DVT was pooled using random-effects models, and subgroups were established according to study type, detection method, sample size and fracture site.

RESULTS

Twenty-three articles reporting on 18,119 patients were eligible. The overall pooled preoperative DVT prevalence was 24.1% (95% CI 19.3-28.8%). In different subgroups, the preoperative DVT prevalences were 18.2-27.3%, 15.2-28.6%, 23.1-24.9%, 18.2-26.0% and 23.2-23.4% for different study designs, sample sizes, age groups, detection methods and fracture sites, respectively.

CONCLUSIONS

Despite the heterogeneity among studies, this systematic review suggests that the prevalence of preoperative DVT, which may seriously affect the prognosis of patients, is high. Therefore, greater efforts should be devoted to the improvement of screening and prevention strategies for preoperative DVT in lower-extremity long bone fractures.

LEVEL OF EVIDENCE

Level III. Trial Registration The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database with the registration number CRD42022324706.

摘要

背景

下肢长骨(包括股骨、胫骨和腓骨)骨折患者术前深静脉血栓(DVT)的患病率数据较少。我们进行了一项荟萃分析来解决这个问题。

方法

系统检索了 PubMed、EMBASE、Web of Science、Cochrane 图书馆、VIP 数据库、CNKI 和万方数据库,以获取 2016 年 1 月至 2021 年 9 月期间报告下肢长骨骨折患者术前 DVT 患病率的原始文章。使用随机效应模型汇总术前 DVT 的患病率,并根据研究类型、检测方法、样本量和骨折部位建立亚组。

结果

有 23 篇文章报告了 18119 名患者符合条件。总的术前 DVT 患病率为 24.1%(95%CI 19.3-28.8%)。在不同的亚组中,术前 DVT 的患病率分别为 18.2-27.3%、15.2-28.6%、23.1-24.9%、18.2-26.0%和 23.2-23.4%,分别用于不同的研究设计、样本量、年龄组、检测方法和骨折部位。

结论

尽管研究之间存在异质性,但本系统评价表明术前 DVT 的患病率较高,这可能严重影响患者的预后。因此,应更加努力改善下肢长骨骨折术前 DVT 的筛查和预防策略。

证据水平

III 级。试验注册:该研究在国际前瞻性系统评价注册库(PROSPERO)中注册,注册号为 CRD42022324706。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad4/10167078/ea129787dce8/10195_2023_699_Fig1_HTML.jpg

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