在接受髋关节置换术治疗髋部骨折的老年患者中，囊外髋部骨折比囊内髋部骨折更易发生围手术期血栓形成：一项回顾性队列研究。

Extracapsular hip fractures are more prone to perioperative thrombosis than intracapsular hip fractures in elderly patients undergoing arthroplasty for hip fractures: a retrospective cohort study.

作者信息

Sun Min, Long Chengbin, Zou Yinshuang, Hu Yong, Chen Cheng, Hu Ning

机构信息

Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan Province, China.

Department of Orthopedics, Bishan Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Eur J Orthop Surg Traumatol. 2025 May 12;35(1):186. doi: 10.1007/s00590-025-04288-3.

DOI:10.1007/s00590-025-04288-3

PMID:40355772

Abstract

PURPOSE

Whether fracture site has any effect on perioperative deep vein thrombosis (DVT) in elderly patients with hip fractures undergoing arthroplasty is still controversial. This study aimed to evaluate the association between fracture site and perioperative DVT in elderly patients undergoing hip arthroplasty.

METHODS

A retrospective cohort analysis was conducted on elderly hip fracture patients who underwent hip arthroplasty and were admitted between January 2015 and December 2021. Patient data, including demographics, comorbidities, injury-related information, laboratory test results at admission, and surgery-related information, were collected. Univariate and multivariate regression analyses, along with subgroup analyses and sensitive analysis, were performed to identify the association between fracture site and DVT.

RESULTS

The study included 593 patients, consisting of 353 patients with intracapsular hip fractures (ICF) and 240 patients with extracapsular hip fractures (ECF), with an average age of 80.7 ± 7.6. The incidence of DVT diagnosed by ultrasonography was 16.9% in all patients. The prevalence of DVT for ECF patients and ICF patients was 22.5% and 13.0%, respectively. In all adjusted multivariate regression analysis model, ECF patients exhibited an increased risk of DVT compared to ICF patients (OR 2.03; 95% CI 1.19-3.47, p = 0.009). Subgroup analyses revealed that female patients with ECF had a higher likelihood of DVT than those with ICF (OR 2.25; 95% CI 1.22-4.13), as did patients aged 65 to 80 years (OR 4.06; 95% CI 1.44-11.41), patients with hemoglobin levels above 110 g/L (OR 2.30; 95% CI 1.08-4.92), and patients with albumin levels above 35 g/L (OR 2.47; 95% CI 1.29-4.73). Sensitivity analysis found similar results.

CONCLUSION

The findings indicate a significant association between fracture site and perioperative DVT in elderly hip fracture patients undergoing hip arthroplasty, with ECF patients demonstrating a higher likelihood of developing DVT than ICF patients.

摘要

目的

骨折部位对接受关节置换术的老年髋部骨折患者围手术期深静脉血栓形成（DVT）是否有影响仍存在争议。本研究旨在评估老年髋部置换术患者骨折部位与围手术期DVT之间的关联。

方法

对2015年1月至2021年12月期间接受髋部置换术的老年髋部骨折患者进行回顾性队列分析。收集患者数据，包括人口统计学、合并症、损伤相关信息、入院时实验室检查结果和手术相关信息。进行单因素和多因素回归分析，以及亚组分析和敏感性分析，以确定骨折部位与DVT之间的关联。

结果

该研究纳入593例患者，其中353例为囊内髋部骨折（ICF）患者，240例为囊外髋部骨折（ECF）患者，平均年龄80.7±7.6岁。所有患者中经超声诊断的DVT发生率为16.9%。ECF患者和ICF患者的DVT患病率分别为22.5%和13.0%。在所有校正的多因素回归分析模型中，与ICF患者相比，ECF患者发生DVT的风险增加（比值比2.03；95%置信区间1.19 - 3.47，p = 0.009）。亚组分析显示，ECF女性患者发生DVT的可能性高于ICF女性患者（比值比2.25；95%置信区间1.22 - 4.13），65至80岁患者（比值比4.06；95%置信区间1.44 - 11.41）、血红蛋白水平高于110 g/L的患者（比值比2.30；95%置信区间1.08 - 4.92）以及白蛋白水平高于35 g/L的患者（比值比2.47；95%置信区间1.29 - 4.73）也是如此。敏感性分析得出了类似结果。