Zeng XiuYun, Zhu Dan, Xiao ZhiFeng, Lin HongLian
Department of Sports Medicine and Traumatology, University Town Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China.
Department of Spine Surgery, University Town Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China.
J Clin Lab Anal. 2025 Apr;39(8):e70019. doi: 10.1002/jcla.70019. Epub 2025 Mar 28.
Deep vein thrombosis (DVT) is a common complication after traumatic lower limb fractures. This study aims to investigate the risk factors associated with DVT after traumatic lower limb fractures and to analyze their values in clinical practice.
Patients were classified into DVT and Non-DVT groups based on the occurrence of DVT during the perioperative period. These data were statistically analyzed to screen for risk factors for DVT after traumatic lower limb fractures and to analyze thrombus regression 1 month after surgery.
DVT occurred in 39.29% (77/196) patients during the perioperative period. The incidence of DVT varied, with a high incidence of 46.67% for femoral neck/trochanteric fractures. Patients in the DVT group were characterized by older age, higher perioperative blood transfusion (both p < 0.001), higher fibrinogen (FIB) on admission (p < 0.001), significant postoperative Hb decline (p = 0.023) and higher D-D (p = 0.001). Age greater than 65 years, comorbid diabetes mellitus, and postoperative Hb decline of 30 g/L were independent risk factors for DVT in the perioperative period in patients with traumatic lower limb fractures. For every 1 SD increase in FIB and D-D, patients had a 1.01-fold (95% CI, 0.99 to 4.25) and 2.75-fold (95% CI, 1.055 to 7.25) increased risk of DVT, respectively.
DVT complicating traumatic lower limb fractures is strongly associated with a variety of risk factors, of which advanced age and significantly higher D-D on admission are two of the most critical.
下肢创伤性骨折后深静脉血栓形成（DVT）是一种常见并发症。本研究旨在探讨下肢创伤性骨折后与DVT相关的危险因素，并分析其在临床实践中的价值。
根据围手术期DVT的发生情况将患者分为DVT组和非DVT组。对这些数据进行统计分析，以筛选下肢创伤性骨折后DVT的危险因素，并分析术后1个月血栓的消退情况。
围手术期39.29%（77/196）的患者发生DVT。DVT的发生率各不相同，股骨颈/转子间骨折的发生率高达46.67%。DVT组患者的特点是年龄较大、围手术期输血较多（均p＜0.001）、入院时纤维蛋白原（FIB）较高（p＜0.001）、术后血红蛋白显著下降（p = 0.023）和D-二聚体较高（p = 0.001）。年龄大于65岁、合并糖尿病以及术后血红蛋白下降30g/L是下肢创伤性骨折患者围手术期DVT的独立危险因素。FIB和D-二聚体每增加1个标准差，患者发生DVT的风险分别增加1.01倍（95%CI，0.99至4.25）和2.75倍（95%CI，1.055至7.25）。
下肢创伤性骨折并发DVT与多种危险因素密切相关，其中高龄和入院时D-二聚体显著升高是两个最关键的因素。
