Cheng Peiyao, Cheng Bo, Wu Linqin, Zhang Hui, Yang Yitong
Department of Anaesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Anaesthesiology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
BMC Musculoskelet Disord. 2024 Dec 6;25(1):1005. doi: 10.1186/s12891-024-08135-0.
The relationship between thromboelastogram (TEG) hypercoagulation status and perioperative deep vein thrombosis (DVT) in patients with femoral and pelvic fractures is not well understood. We aimed to investigate the relationship between hypercoagulation status identified by thromboelastography and postoperative DVT formation in patients with femoral and pelvic fractures, as well as to evaluate the role of thromboelastography in assessing hypercoagulation status and predicting postoperative DVT formation.
Data from 2,065 patients with femoral and pelvic fractures who underwent surgical treatment at a hospital in China between May 2018 and December 2023 were retrospectively analysed. Hypercoagulable TEG was defined as reaction time (R) < 5 min, coagulation time (K) < 1 min, alpha angle (α) > 72 degrees, maximum amplitude (MA) > 70 mm, and/or coagulation index (CI) > 3. The correlation between preoperative hypercoagulability identified by TEG and postoperative DVT formation was assessed using multivariate logistic regression. Propensity score matching (PSM) was performed to control for confounding factors.
Compared to the non-DVT group, the DVT group had decreased R and K values, while the α, MA, and CI values significantly increased (P < 0.05). Multivariate logistic regression analysis demonstrated that hypercoagulable TEG findings were predictive of postoperative DVT formation. PSM, using a 0.1 calliper value, matched 296 patients from the hypercoagulation and non-hypercoagulation groups in a 1:1 ratio. Before PSM, hypercoagulable TEG was associated with DVT in femoral and pelvic fractures (P < 0.001, odds ratio [OR]:1.860, 95% confidence interval: 1.389-2.492). After PSM, these two variables remained correlated (P = 0.001, OR = 1.878, 95% confidence interval:1.301 - 2.709).
The hypercoagulable state identified by TEG can predict thromboembolic events in patients with femoral and pelvic fractures.
The study was registered in the Chinese Clinical Trial Register ( https://www.chictr.org.cn/bin/home ) on April 16, 2024, with registration number ChiCTR2400083135.
目前对于股骨干骨折和骨盆骨折患者血栓弹力图（TEG）高凝状态与围手术期深静脉血栓形成（DVT）之间的关系尚不清楚。我们旨在研究通过血栓弹力图确定的高凝状态与股骨干骨折和骨盆骨折患者术后DVT形成之间的关系，并评估血栓弹力图在评估高凝状态和预测术后DVT形成中的作用。
回顾性分析了2018年5月至2023年12月在中国一家医院接受手术治疗的2065例股骨干骨折和骨盆骨折患者的数据。TEG高凝状态定义为反应时间（R）<5分钟、凝血时间（K）<1分钟、α角（α）>72度、最大振幅（MA）>70毫米和/或凝血指数（CI）>3。采用多因素logistic回归分析评估术前TEG确定的高凝状态与术后DVT形成之间的相关性。进行倾向得分匹配（PSM）以控制混杂因素。
与非DVT组相比，DVT组的R值和K值降低，而α值、MA值和CI值显著升高（P<0.05）。多因素logistic回归分析表明，TEG高凝结果可预测术后DVT形成。使用0.1卡尺值进行PSM，以1:1的比例匹配了高凝组和非高凝组的296例患者。在PSM之前，TEG高凝与股骨干骨折和骨盆骨折中的DVT相关（P<0.001，比值比[OR]：1.860，95%置信区间：1.389-2.492）。PSM之后，这两个变量仍然相关（P=0.001，OR=1.878，95%置信区间：1.301-）。
TEG确定的高凝状态可预测股骨干骨折和骨盆骨折患者的血栓栓塞事件。
该研究于2024年4月16日在中国临床试验注册中心（https://www.chictr.org.cn/bin/home）注册登记号为ChiCTR2400083135。 2.709
