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[老年髋部骨折患者术前深静脉血栓形成的发生率及其危险因素]

[Preoperative Incidence of Deep Venous Thrombosis and Its Risk Factors in Older Patients with Hip Fracture].

作者信息

Pan Tingming, Zhong Dong, Zhang Hongjie, Xu Jinchao, Guan Jianwei, Peng Xiang

机构信息

Department of Orthopedics, Fujian Provincial Second People's Hospital, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China.

出版信息

Acta Chir Orthop Traumatol Cech. 2025 Jun;92(2):92-97. doi: 10.55095/achot2024/062.

Abstract

PURPOSE OF THE STUDY

Hip fractures in the elderly are commonly complicated by deep venous thrombosis (DVT), particularly in the preoperative phase. This retrospective study aimed to determine the preoperative incidence of DVT and identify its risk factors in older patients with hip fractures.

MATERIAL AND METHODS

This single-center retrospective study enrolled 278 patients (aged ≥ 60 years) with unilateral hip fracture, who underwent color Doppler ultrasonography of the lower extremity veins on the day of surgery at the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine between 1st January 2015 and 31st December 2020. Demographic data, clinical characteristics, and surgical history were analyzed. Multivariate logistic regression was used to identify independent risk factors for preoperative DVT.

RESULTS

The incidence of DVT was 15.5%, including peripheral venous thrombosis at 18.6% and central venous thrombosis at 5.4%. Univariate analysis showed no significant differences in gender, age, and type of fracture. However, delayed admission, longer time from admission to surgery, and atrial fibrillation were significant risk factors. Multivariate logistic regression analysis identified delayed admission (OR = 2.597, 95% CI 1.275-5.290, P = .009), prolonged time from admission to surgery (OR = 1.166, 95% CI 1.034-1.314, P = .012), and atrial fibrillation (OR = 2.848, 95% CI 1.115-7.275, P = .029) as significant independent risk factors for DVT.

CONCLUSIONS

Early admission and prompt surgery of elderly patients with hip fractures are critical to prevent the occurrence of DVT. Atrial fibrillation remains a significant risk factor that requires close attention. Prospective studies are warranted to validate these findings and optimize prophylactic strategies.

摘要

研究目的

老年髋部骨折常并发深静脉血栓形成(DVT),尤其是在术前阶段。本回顾性研究旨在确定老年髋部骨折患者术前DVT的发生率,并识别其危险因素。

材料与方法

本单中心回顾性研究纳入了278例年龄≥60岁的单侧髋部骨折患者,这些患者于2015年1月1日至2020年12月31日在福建中医药大学附属第二人民医院手术当天接受了下肢静脉彩色多普勒超声检查。分析了人口统计学数据、临床特征和手术史。采用多因素logistic回归分析确定术前DVT的独立危险因素。

结果

DVT的发生率为15.5%,其中外周静脉血栓形成发生率为18.6%,中心静脉血栓形成发生率为5.4%。单因素分析显示,性别、年龄和骨折类型无显著差异。然而,延迟入院、入院至手术时间延长和心房颤动是显著的危险因素。多因素logistic回归分析确定延迟入院(OR = 2.597,95%CI 1.275 - 5.290,P = 0.009)、入院至手术时间延长(OR = 1.166,95%CI 1.034 - 1.314,P = 0.012)和心房颤动(OR = 2.848,95%CI 1.115 - 7.275,P = 0.029)是DVT的显著独立危险因素。

结论

老年髋部骨折患者早期入院并及时手术对于预防DVT的发生至关重要。心房颤动仍然是一个需要密切关注的重要危险因素。有必要进行前瞻性研究以验证这些发现并优化预防策略。

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