Abstract
ObjectiveThe purpose of this study was to investigate the incidence, location, and related factors of deep venous thrombosis (DVT) of the bilateral lower extremities after intertrochanteric fractures in the elderly.MethodsRetrospective analysis was performed on the elderly patients with intertrochanteric fracture who were admitted from January 2017 to December 2019. At admission, patients receive routine ultrasound Doppler scanning of bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Patient data on demographics, comorbidities, injury-related data, and laboratory test results at admission were extracted. Logistic regression analyses were conducted to identify the independent risk factors associated with DVT.ResultsFive hundred seventy-eight patients were included, among whom 116 (20.1%) had DVT. Among those with DV, 70.7% (82/116) had DVT of the distal type, 24 (29.6%) had DVT of the proximal type, and 10 (10.4%) had mixed DVT. In 76.7% (89/116) of patients, DVT occurred in the fractured extremity, 9.5% (11/116) in the bilateral and 13.8% (16/116) in the non-fractured extremity. Multivariate analyses identified obesity, delay to admission, increased D-dimer level (> 1.44 mg/L) and reduced albumin (< 31.7 g/L) as independent factors.ConclusionsAdmission incidence of DVT was high in elderly patients with intertrochanteric fractures, especially the proximal DVT. Identification of associated risk factors is useful for individualized assessment risk of DVT and early targeted interventions.
Highlights
Intertrochanteric fracture is one of the most common fractures in the elderly, constituting 10~20% of all fractures and 50–65% of hip fractures [1, 2]
It was reported that intertrochanteric fracture itself was a risk factor for deep venous thrombosis (DVT), increasing 2.5-fold risk compared to femoral neck fracture [4]
In 76.7% (89/116) of patients, DVT occurred in the fractured extremity, 9.5% (11/116) in the bilateral and 13.8% (16/116) in the non-fractured extremity
Summary
Intertrochanteric fracture is one of the most common fractures in the elderly, constituting 10~20% of all fractures and 50–65% of hip fractures [1, 2]. Intertrochanteric fractures are typical osteoporotic fractures and are most commonly caused by low-energy fall injury, with a 1-month mortality of 5–10% and 1-year mortality rate of. After an intertrochanteric fracture occurs, the hypercoagulability of blood, post-trauma stress/inflammatory immune response of the body place the patients at a high risk of DVT. It was reported that intertrochanteric fracture itself was a risk factor for DVT, increasing 2.5-fold risk compared to femoral neck fracture [4]. The high prevalence of multiple comorbidities made elderly patients more susceptible to DVTs than younger patients [5]. Pulmonary embolism (PE) is the third leading cause of death within 24 hours after trauma, and DVT is a most predominant source of
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