小腿肌间静脉血栓形成对老年髋部骨折患者术后1年内预后的影响：一项倾向评分匹配分析
The effect of calf muscular vein thrombosis on the prognosis within one year postoperatively of geriatric hip fracture patients: a propensity score-matched analysis.
作者信息
Jiang Jiabao, Xing Fei, Luo Rong, Chen Zhao, Liu Hao, Xiang Zhou, Duan Xin
机构信息
Department of Orthopedic Surgery, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, Sichuan, China.
Department of Pediatric Surgery, Division of Orthopedic Surgery, Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
出版信息
BMC Geriatr. 2024 Dec 31;24(1):1050. doi: 10.1186/s12877-024-05601-1.
INTRODUCTION
Calf muscular vein thrombosis (CMVT) is a type of distal deep vein thrombosis, which is common in geriatric hip fracture patients. However, studies focusing on whether the orthopedic operation has an impact on the prognosis of geriatric hip fracture patients with CMVT are very limited. Therefore, the aim of this study was to explore whether geriatric hip fractures with CMVT affect the mortality of patients within one year postoperatively. The difficulty of the operation, postoperative complications, the status of thrombosis, and function scores were also compared.
MATERIALS AND METHODS
Geriatric hip fracture patients who underwent surgery between January 2019 and January 2021 were included. Patients were divided into groups with and without CMVT by preoperative color Doppler ultrasound examination. Propensity score-matching (PSM) was performed in a ratio of 1:1 between the patient with and without CMVT groups. Baseline characteristics, laboratory results, perioperative indicators and prognosis of patients were collected retrospectively. Intraoperative and postoperative comparisons were conducted between patients with and without CMVT.
RESULTS
Two hundred and sixty geriatric hip fracture patients were included. Eighty-nine patients in each group were matched after PSM. There was no significant difference in mortality between the two groups at one-month, three-month, six-month, and one-year postoperatively. However, patients with CMVT had longer hospital stays, a higher incidence of postoperative complications, and a higher incidence of thrombosis progression than patients without CMVT in the follow-up.
CONCLUSION
No significant difference in mortality within one year postoperatively was observed in Chinese geriatric hip fracture patients with or without CMVT formation. Strategies such as close monitoring the status of thrombosis, individualized care, and strengthening rehabilitation are recommended to reduce the risk of complications and optimize patient outcomes in this patient population.
TRIAL REGISTRATION
Chinese Clinical Trial Registry (ChiCTR2300069411). Registered March 15, 2023, https://www.chictr.org.cn/showproj.html?proj=192079 .
引言
小腿肌肉静脉血栓形成（CMVT）是一种远端深静脉血栓形成，在老年髋部骨折患者中很常见。然而，关注骨科手术对患有CMVT的老年髋部骨折患者预后是否有影响的研究非常有限。因此，本研究的目的是探讨患有CMVT的老年髋部骨折是否会影响患者术后一年内的死亡率。还比较了手术难度、术后并发症、血栓形成情况和功能评分。
材料与方法
纳入2019年1月至2021年1月期间接受手术的老年髋部骨折患者。术前通过彩色多普勒超声检查将患者分为有CMVT组和无CMVT组。对有CMVT组和无CMVT组患者按1:1的比例进行倾向评分匹配（PSM）。回顾性收集患者的基线特征、实验室检查结果、围手术期指标和预后情况。对有CMVT组和无CMVT组患者进行术中及术后比较。
结果
纳入260例老年髋部骨折患者。PSM后每组匹配89例患者。术后1个月、3个月、6个月和1年时，两组死亡率无显著差异。然而，在随访中，与无CMVT的患者相比，有CMVT的患者住院时间更长，术后并发症发生率更高，血栓进展发生率更高。
结论
中国老年髋部骨折患者中，有或无CMVT形成的患者术后一年内死亡率无显著差异。建议采取密切监测血栓形成情况、个体化护理和加强康复等策略，以降低该患者群体的并发症风险并优化患者预后。
试验注册
中国临床试验注册中心（ChiCTR2300069411）。于2023年3月15日注册，https://www.chictr.org.cn/showproj.html?proj=192079 。
Zotero 插件