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髋部骨折后延迟手术会影响静脉血栓栓塞症的发生率。

Delayed surgery after hip fracture affects the incidence of venous thromboembolism.

机构信息

Department of Orthopaedic Surgery, Kobe Red Cross Hospital, Kobe City, Hyogo, 651-0073, Japan.

出版信息

J Orthop Surg Res. 2023 Aug 28;18(1):630. doi: 10.1186/s13018-023-04122-8.

DOI:10.1186/s13018-023-04122-8
PMID:37641109
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10463883/
Abstract

BACKGROUND

Venous thromboembolism (VTE) is one of the most common complications of hip fracture surgeries, and it is unclear whether delayed surgery affects the incidence of VTE. This study aimed to examine the association between delayed surgery and VTE incidence by statistically adjusting for factors that may influence VTE incidence.

METHODS

We included 862 patients ≥ 65 years with hip fractures who underwent surgery between October 2010 and December 2020. We examined the effect of surgical delay 48 h after injury on postoperative VTE. Patients with and without VTE were assigned to groups V and NV, respectively. Those with and without proximal deep venous thrombosis (DVT) were assigned to PD and NPD groups, respectively. Univariate analysis was performed to identify factors that might influence DVT development. Risk factors for developing VTE and proximal DVT were analyzed using logistic regression analysis to determine whether delayed surgery was a risk factor.

RESULTS

VTE was observed in 436 patients (40%) and proximal DVT in 48 patients (5.6%). Univariate analysis showed significant differences in the time from trauma to surgery between the V and NV groups and between the PD and NPD groups. In multivariate analysis, surgery 48 h later was also a risk factor for developing VTE and proximal DVT.

CONCLUSION

A delay in surgery beyond 48 h after a hip fracture injury is a risk factor for developing VTE and proximal DVT.

摘要

背景

静脉血栓栓塞症(VTE)是髋部骨折手术后最常见的并发症之一,目前尚不清楚手术延迟是否会影响 VTE 的发生率。本研究旨在通过统计学调整可能影响 VTE 发生率的因素,来检验手术延迟与 VTE 发生率之间的关联。

方法

我们纳入了 862 名≥65 岁的髋部骨折患者,这些患者在 2010 年 10 月至 2020 年 12 月期间接受了手术。我们考察了损伤后 48 小时手术对术后 VTE 的影响。发生 VTE 和未发生 VTE 的患者分别被分配到 V 组和 NV 组。发生近端深静脉血栓(DVT)和未发生近端 DVT 的患者分别被分配到 PD 组和 NPD 组。我们进行了单变量分析,以确定可能影响 DVT 发展的因素。使用逻辑回归分析来分析发生 VTE 和近端 DVT 的风险因素,以确定手术延迟是否是一个风险因素。

结果

436 名患者(40%)发生了 VTE,48 名患者(5.6%)发生了近端 DVT。单变量分析显示,V 组和 NV 组以及 PD 组和 NPD 组之间从创伤到手术的时间存在显著差异。在多变量分析中,48 小时后手术也是发生 VTE 和近端 DVT 的一个风险因素。

结论

髋部骨折损伤后超过 48 小时的手术延迟是发生 VTE 和近端 DVT 的一个风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c09/10463883/7ab6f5cbaafc/13018_2023_4122_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c09/10463883/7ab6f5cbaafc/13018_2023_4122_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c09/10463883/7ab6f5cbaafc/13018_2023_4122_Fig1_HTML.jpg

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