Wen Feng-Li, Xiao Yu-Chen, Ailihemaiti Ayidan, Zheyiken Jiangannuer
Department of Orthopaedics, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine, Xinjiang, China.
Department of Orthopaedics, Traditional Chinese Medicine Hospital of Ili Kazakh Autonomous Prefecture, Xinjiang, China.
Medicine (Baltimore). 2025 Jun 27;104(26):e42997. doi: 10.1097/MD.0000000000042997.
The aim was to investigate the independent risk factors affecting the formation of lower extremity deep vein thrombosis (DVT) after intertrochanteric fracture of the femur, and to propose corresponding preventive measures. Data were collected from patients who underwent intertrochanteric femur fracture surgery in our hospital during the period from January 2020 to December 2023, and the independent risk factors for the formation of postoperative lower limb DVT were determined by univariate and multivariate logistic regression analyses, which led to the construction of the corresponding Nomogram model. The performance of the model was assessed by plotting the subjects' work characteristic curve and its corresponding area under the curve, as well as calibration curve and decision curve analysis. A total of 627 patients with intertrochanteric femoral fractures were included in the study, of whom 156 had postoperative thrombosis, with an incidence rate of 24.88%. By univariate and multivariate logistic regression analyses, 5 independent risk factors associated with lower extremity DVT formation after intertrochanteric femur fracture were identified, including age >75 years (OR: 1.719; 95% CI: 1.094-4.105), body mass index >24 (OR: 2.190; 95% CI: 1.610-2.899), history of preoperative diabetes mellitus (OR: 1.511; 95% CI: 1.079-2.115), high-energy injury (OR: 4.184; 95% CI: 1.977-8.858), and fracture-to-operation time of more than 48 hours (OR: 2.666; 95% CI: 1.964-4.342). The Nomogram model constructed in this study for DVT formation in the lower limb after femoral intertrochanteric fracture showed high predictive accuracy, which can help orthopedic surgeons to identify high-risk patients and intervene early to reduce the occurrence of postoperative DVT.
目的是探讨影响股骨转子间骨折后下肢深静脉血栓形成(DVT)的独立危险因素,并提出相应的预防措施。收集2020年1月至2023年12月期间在我院接受股骨转子间骨折手术患者的数据,通过单因素和多因素logistic回归分析确定术后下肢DVT形成的独立危险因素,进而构建相应的列线图模型。通过绘制受试者工作特征曲线及其相应的曲线下面积、校准曲线和决策曲线分析来评估模型的性能。本研究共纳入627例股骨转子间骨折患者,其中156例发生术后血栓形成,发生率为24.88%。通过单因素和多因素logistic回归分析,确定了与股骨转子间骨折后下肢DVT形成相关的5个独立危险因素,包括年龄>75岁(OR:1.719;95%CI:1.094 - 4.105)、体重指数>24(OR:2.190;95%CI:1.610 - 2.899)、术前糖尿病史(OR:1.511;95%CI:1.079 - 2.115)、高能损伤(OR:4.184;95%CI:1.977 - 8.858)以及骨折至手术时间超过48小时(OR:2.666;95%CI:1.964 - 4.342)。本研究构建的股骨转子间骨折后下肢DVT形成的列线图模型显示出较高的预测准确性,有助于骨科医生识别高危患者并早期干预,以减少术后DVT的发生。