Abstract
BackgroundThe relationship between perioperative red blood cell (RBC) infusion and deep vein thrombosis (DVT) has not been determined.ObjectivesTo analyze the time-event relationship between perioperative RBC infusion and DVT in patients with femoral and pelvic fractures after adjusting for confounding factors and to provide reference for optimizing DVT risk factors.MethodsThe clinical data of 569 patients with femoral and pelvic fractures who received surgical treatment from May 2018 to December 2019 were retrospectively analyzed. Propensity score matching (PSM) was performed on 20 covariates of DVT. With the formation or progression of DVT after RBC infusion as the end point, the time-event relationship between perioperative RBC infusion and DVT in patients was analyzed by binary logistic regression.ResultsAfter 1:1 PSM of 569 patients included in this study, 126 patients were in the transfusion group and the non-transfusion group, respectively. Before PSM (P = 0.023, OR = 1.496 [95% CI, 1.058-2.115]), perioperative RBC infusion was associated with DVT formation for femoral and pelvic fractures. This conclusion was still obtained after PSM (P = 0.038, OR = 1.728, 95% CI = (1.031, 2.896)). The risk of DVT in patients with RBC infusion of 2-4U and > 4U is 1.833 and 2.667 times that of ≤ 2U, respectively. After excluding patients who received preoperative RBC infusion and had DVT formation or progression prior to RBC infusion, perioperative RBC infusion was still associated with the formation of DVT in femoral and pelvic fractures (P = 0.037, OR = 2.231 [95% CI, 1.049-4.745]).ConclusionPerioperative RBC infusion is one of the causes of DVT in patients with femoral and pelvic fractures, and the risk of DVT is positively correlated with the amount of RBC infusion.
Highlights
Bone trauma patients are the high-risk population for the formation of deep vein thrombosis (DVT), because most of them simultaneously have blood hypercoagulation [1], vascular endothelium injury caused by trauma and surgery, long-term immobilization, and blood stasis caused by edema of surrounding tissues
After controlling for confounders by Propensity score matching (PSM), if perioperative red blood cell (RBC) infusion was associated with the occurrence of DVT, the formation or progression of DVT after RBC infusion was taken as the end point of the event to further explore the causal relationship between the two
Analysis of the time-event relationship between perioperative RBC infusion and DVT In conclusion, Perioperative RBC infusion is one of the causes of DVT in patients with femoral and pelvic fractures, and the risk of DVT is positively correlated with the amount of perioperative RBC infusion
Summary
Bone trauma patients are the high-risk population for the formation of DVT, because most of them simultaneously have blood hypercoagulation [1], vascular endothelium injury caused by trauma and surgery, long-term immobilization, and blood stasis caused by edema of surrounding tissues. According to research reports in recent years, the prevention and treatment of DVT have reduced the incidence of above mentioned to 10-20% [5,6,7]. In the face of this relatively high incidence of DVT, we need to further explore the optimized risk factors for DVT. These factors can be optimized through early identification and timely medical intervention. Most studies have reported that perioperative RBC infusion increases the risk of DVT [8,9,10,11,12,13], while some researchers have found no correlation between the two events [14,15,16]. The relationship between perioperative red blood cell (RBC) infusion and deep vein thrombosis (DVT) has not been determined
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
