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足踝手术后深静脉血栓形成的发病率及危险因素

Incidence and Risk Factors of Deep Vein Thrombosis after Foot and Ankle Surgery.

作者信息

Park Young Uk, Kim Hyong Nyun, Cho Jae Ho, Kim Taehun, Kang Gunoo, Seo Young Wook

机构信息

Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.

Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

出版信息

Clin Orthop Surg. 2024 Dec;16(6):994-1000. doi: 10.4055/cios24163. Epub 2024 Nov 15.

Abstract

BACKGROUND

Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery.

METHODS

Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgery-related data, such as tourniquet time.

RESULTS

Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 ( = 0.04), 6.40 ( = 0.02), and 1.16 ( = 0.03), respectively.

CONCLUSIONS

After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

摘要

背景

深静脉血栓形成(DVT)是骨科手术中常见的并发症,有可能导致诸如肺血栓栓塞等致命并发症。然而,足踝领域DVT的确切发病率和危险因素仍不清楚。本研究旨在分析足踝手术后DVT的患病率并确定其危险因素。

方法

在2020年9月至2023年7月期间,对278例行足踝手术且需要固定的患者进行双功超声筛查。结合诊断时出现的症状评估双功超声筛查结果。检查可能作为DVT潜在危险因素的异质人口统计学数据,包括诊断、体重指数和其他病史,以及相关的手术相关数据,如止血带时间。

结果

在这278例患者中,41例(14.7%)发生了DVT。其中,92.7%起源于小腿水平,且大多数无症状。小腿以上起源的病例有3例,占诊断为DVT患者的7.3%(占整个筛查人群的1.1%)。急性创伤、既往DVT病史和高龄被确定为DVT发生的统计学显著危险因素,比值比分别为2.44( = 0.04)、6.40( = 0.02)和1.16( = 0.03)。

结论

足踝手术后,14.7%的病例发生了DVT。急性创伤、DVT病史和高龄被确定为DVT的危险因素。这些发现凸显了对高危患者进行仔细监测和适当预防性干预的必要性。需要进一步研究以确定针对该患者群体的有效预防策略。

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本文引用的文献

1
Pathophysiology of deep vein thrombosis.深静脉血栓形成的病理生理学。
Clin Exp Med. 2023 Jul;23(3):645-654. doi: 10.1007/s10238-022-00829-w. Epub 2022 Apr 26.

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