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创伤性下肢骨折后深静脉血栓形成的危险因素:系统评价和荟萃分析。

Risk factors for deep vein thrombosis after traumatic lower extremity fracture: A systematic review and meta-analysis.

机构信息

Department of Orthopaedics, The First People's Hospital of Linping District of Hangzhou, Hangzhou City, China.

出版信息

Medicine (Baltimore). 2024 Jun 7;103(23):e38439. doi: 10.1097/MD.0000000000038439.

Abstract

BACKGROUND

The study aimed to predict the risk factors of deep vein thrombosis of lower extremity after traumatic fracture of lower extremity, so as to apply effective strategies to prevent deep vein thrombosis of lower extremity, improve survival rate, and reduce medical cost.

METHODS

The English and Chinese literatures published from January 2005 to November 2023 were extracted from PubMed, Embase, Willey Library, Scopus, CNKI, Wanfang, and VIP databases. Statistical analysis was performed using Stata/SE 16.0 software.

RESULTS

A total of 13 articles were included in this paper, including 2699 venous thromboembolism (VTE) patients and 130,507 normal controls. According to the meta-results, 5 independent risk factors can be identified: history of VTE was the most significant risk factor for deep vein thrombosis after traumatic lower extremity fracture (risk ratio [RR] = 6.45, 95% confidence interval [CI]: 1.64-11.26); age (≥60) was the risk factor for deep vein thrombosis after traumatic lower extremity fracture (RR = 1.60, 95% CI: 1.02-2.18); long-term braking was a risk factor for deep vein thrombosis after traumatic lower extremity fracture (RR = 1.52, 95% CI: 1.11-1.93); heart failure was a risk factor for deep vein thrombosis after traumatic lower extremity fracture (RR = 1.92, 95% CI: 1.51-2.33); obesity was a risk factor for deep vein thrombosis after traumatic lower extremity fracture (RR = 1.59, 95% CI: 1.35-1.83).

CONCLUSION

The study confirmed that the history of deep vein thrombosis, age (60 + years), previous history of VTE, obesity, prolonged bed rest, and heart failure are all associated with an increased risk of VTE. By identifying these significant risk factors, we can more intensively treat patients at relatively high risk of VTE, thereby reducing the incidence of VTE. However, the limitation of the study is that the sample may not be diversified enough, and it fails to cover all potential risk factors, which may affect the universal applicability of the results. Future research should include a wider population and consider more variables in order to obtain a more comprehensive risk assessment.

摘要

背景

本研究旨在预测下肢创伤性骨折后下肢深静脉血栓形成的危险因素,以便应用有效的策略预防下肢深静脉血栓形成,提高生存率,降低医疗费用。

方法

从 PubMed、Embase、Wiley 图书馆、Scopus、CNKI、万方和 VIP 数据库中提取 2005 年 1 月至 2023 年 11 月发表的英文和中文文献。使用 Stata/SE 16.0 软件进行统计分析。

结果

本文共纳入 13 篇文献,共纳入 2699 例静脉血栓栓塞(VTE)患者和 130507 例正常对照。Meta 分析结果显示,有 5 个独立的危险因素:VTE 史是创伤性下肢骨折后深静脉血栓形成的最显著危险因素(风险比[RR] = 6.45,95%置信区间[CI]:1.64-11.26);年龄(≥60 岁)是创伤性下肢骨折后深静脉血栓形成的危险因素(RR = 1.60,95%CI:1.02-2.18);长期制动是创伤性下肢骨折后深静脉血栓形成的危险因素(RR = 1.52,95%CI:1.11-1.93);心力衰竭是创伤性下肢骨折后深静脉血栓形成的危险因素(RR = 1.92,95%CI:1.51-2.33);肥胖是创伤性下肢骨折后深静脉血栓形成的危险因素(RR = 1.59,95%CI:1.35-1.83)。

结论

本研究证实,深静脉血栓形成史、年龄(60 岁以上)、既往 VTE 史、肥胖、长期卧床休息和心力衰竭均与 VTE 风险增加相关。通过识别这些显著的危险因素,我们可以更集中地治疗 VTE 风险较高的患者,从而降低 VTE 的发生率。然而,研究的局限性在于样本可能不够多样化,未能涵盖所有潜在的危险因素,这可能会影响结果的普遍适用性。未来的研究应包括更广泛的人群,并考虑更多的变量,以获得更全面的风险评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/debe/11155550/2fa90555d523/medi-103-e38439-g001.jpg

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