髌骨骨折患者的深静脉血栓形成：评估发病率并识别危险因素。
Deep vein thrombosis in patients with patellar fractures: Assessing incidence rates and identifying risk factors.
作者信息
Yang Shuo, Zhang Erdong, Li Ziping, Long Yubin, Li Yiran, Zhang Jiaqi, Wang Fei, Liu Lin, Wang Tao, Guo Junfei, Hou Zhiyong
机构信息
Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, P.R. China.
The Third Department of Orthopedics, Baoding First Central Hospital, Baoding, Hebei, P.R. China.
出版信息
PLoS One. 2025 Feb 21;20(2):e0316628. doi: 10.1371/journal.pone.0316628. eCollection 2025.
BACKGROUND
Deep Vein Thrombosis (DVT) represents a significant complication following orthopedic injuries, particularly patellar fractures. Despite the prevalence, comprehensive studies assessing the incidence rates and identifying specific risk factors in patellar fracture patients are limited.
METHODS
This retrospective analysis reviewed electronic medical records from 3311 patients treated for patellar fractures at two tertiary hospitals between November 2013 and January 2023. The study focused on patient demographics, fracture characteristics, comorbidities, and laboratory parameters to evaluate the incidence and predictors of DVT. DVT prophylaxis measures and diagnostic criteria, including Doppler Ultrasound Scans, were rigorously applied.
RESULTS
In patients with patellar fractures, the DVT incidence was 30.8%, with 1,790 clots identified in 1,021 diagnosed individuals, predominantly on the injured side (96.7%), and a minor portion on the uninjured side (3.2%). Key risk factors included older age (P<0.001, OR = 1.038), the presence of open injuries (P = 0.002, OR = 1.521), multiple injuries (P<0.001, OR = 3.623), and prolonged time from injury to surgical treatment (P<0.001, OR = 1.097). Conversely, higher levels of albumin (ALB) (P = 0.029, OR = 0.983) and sodium (Na) (P = 0.028, OR = 0.971) were identified as protective factors against DVT. Besides, ROC curve analysis revealed that the age of 52 years and a duration of 4 days from injury to surgery serve as predictive cut-off values for assessing the risk of DVT.
CONCLUSION
Our study investigates the incidence of thrombosis in patellar fracture patients and identifies key risk factors for DVT, including age, open and multiple injuries, and the time from injury to surgery. Additionally, we highlight sodium and albumin levels as protective factors. By establishing threshold values for age and surgical delay, our findings improve DVT risk assessment, facilitating earlier and more targeted interventions.
背景
深静脉血栓形成（DVT）是骨科损伤后的一种重要并发症，尤其是髌骨骨折。尽管其普遍存在，但评估髌骨骨折患者发病率并确定特定风险因素的综合研究有限。
方法
这项回顾性分析回顾了2013年11月至2023年1月期间在两家三级医院接受髌骨骨折治疗的3311例患者的电子病历。该研究聚焦于患者人口统计学、骨折特征、合并症和实验室参数，以评估DVT的发病率和预测因素。严格应用了包括多普勒超声扫描在内的DVT预防措施和诊断标准。
结果
在髌骨骨折患者中，DVT发病率为30.8%，在1021例确诊患者中发现1790处血栓，主要位于受伤侧（96.7%），小部分位于未受伤侧（3.2%）。关键风险因素包括年龄较大（P<0.001，OR = 1.038）、存在开放性损伤（P = 0.002，OR = 1.521）、多处损伤（P<0.001，OR = 3.623）以及从受伤到手术治疗的时间延长（P<0.001，OR = 1.097）。相反，较高水平的白蛋白（ALB）（P = 0.029，OR = 0.983）和钠（Na）（P = 0.028，OR = 0.971）被确定为预防DVT的保护因素。此外，ROC曲线分析显示，52岁的年龄以及从受伤到手术的4天时间可作为评估DVT风险的预测临界值。
结论
我们的研究调查了髌骨骨折患者的血栓形成发病率，并确定了DVT的关键风险因素，包括年龄、开放性和多处损伤以及从受伤到手术的时间。此外，我们强调钠和白蛋白水平为保护因素。通过确定年龄和手术延迟的阈值，我们的研究结果改进了DVT风险评估，有助于更早、更有针对性地进行干预。
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