Abstract
BackgroundLimited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures.MethodsThis retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Univariate analysis and stepwise backward multivariate logistic regression were used to identify the risk factors contributing to the occurrence of DVT.ResultsThe overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). The mean time from injury to admission was 2.1 days in the total population, 2.96 and 1.87 days in patients with and without DVT. Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, lower Hb value, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P < 0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, lower Hb, diabetes and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT.ConclusionsA high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, surgeons should be aware of the high prevalence of DVT for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.
Highlights
Limited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures
This study provides the first evidence of risk factors for pre-admission DVT in elderly Chinese patients with intertrochanteric fractures
We identified that diabetes was independent risk factor for DVT on admission in patients with intertrochanteric fractures
Summary
Limited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures. Hip fracture is very frequent in the elderly, which is associated with increased disability and mortality [1]. It is estimated that the number of hip fractures is approximately 1.7 million each year, and the number is expected to surpass 6 million by the year 2050 worldwide [2]. When a hip fracture occurs, the risk of venous thromboembolism (VTE) increases obviously in the preoperative period owing to the venous congestion, vascular injury and immobilization [3]. Deep vein thrombosis (DVT) is one of the common complications in patients with hip fractures. Previous studies have shown that the incidence of preoperative DVT in hip fracture patients varied from 2.6 to 17.3%, and could be as high as 62% in the hip fracture patients who had delayed operation [5, 6]
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