Prevalence and risk factors of preoperative deep venous thrombosis in closed patella fracture: a prospective cohort study

Zhanchao Tan,Zhongzheng Wang,Hongzhi Hu,Yingze Zhang,Yuchuan Wang

doi:10.1186/s13018-021-02558-4

Abstract

BackgroundThe preoperative prevalence of deep venous thromboembolism (DVT) of patella fracture is not well established. The study aimed to investigate the preoperative prevalence, the associated risk factors, and the locations of deep venous thrombosis (DVT) in patients with closed patella fracture.MethodsPatients who sustained closed patella fracture between January 1, 2016, and April 1, 2019, were included. Blood analyses and ultrasonography of bilateral lower extremities were routinely performed. Data of demographics, comorbidities, mechanism of injury, fracture type, total hospital stay, time from injury to DVT, and laboratory indexes were prospectively collected and compared between groups with and with non-DVT. Multivariate logistic regression analyses were performed to determine the independent risk factors of DVT.ResultsAmong the study cohort of 790 patients, 35 cases occurred in preoperative DVTs, indicating a prevalence of 4.4%, with 3.2% distal and 1.2% proximal DVT. Age ≥ 65 years old (OR, 3.0, 95% CI, 1.1–8.1), D-dimer > 0.5 mg/L (OR, 2.3, 95% CI, 1.1–4.8), and albumin < 35 g/L (OR, 2.5, 95% CI, 1.2–5.3) were identified to be risk factors of DVT in closed patella fracture. Among the DVTs, 30 cases (85.7%) occurred in the injured extremity, 3 cases (8.6%) in bilateral extremities, and 2 cases (5.7%) solely in the uninjured extremity.ConclusionThe prevalence of preoperative DVT in closed patella fracture was 4.4%, with 3.2% for distal and 1.2% for proximal DVT. We recommend individualized risk stratification and early anticoagulation for patients with risk factors (age ≥ 65 years, D-dimer > 0.5 mg/L and albumin < 35g/L).

Highlights

The preoperative prevalence of deep venous thromboembolism (DVT) of patella fracture is not well established
Significant differences were found in seven variables, including age category, injury mechanism, alcohol consumption, Ddimer > 0.5 mg/L, albumin < 35 g/L, platelet (PLT) > 300 ×109/L, and low-density lipoprotein cholesterol (LDL-C) > 3.37 mmol/L, (p < 0.05)
The seven variables were entered into the final model of the multivariate analysis and three variables were identified to be independent risk factors of the preoperative DVT in closed isolated patella fracture, including age ≥ 65years old, (OR, 3.0, 95% CI, 1.1–8.1), Ddimer > 0.5 mg/L, (OR, 2.3, 95% CI, 1.1–4.8), and albumin < 35 g/L, (OR, 2.5, 95% CI, 1.2–5.3), (Table 2)

Summary

Introduction

The preoperative prevalence of deep venous thromboembolism (DVT) of patella fracture is not well established. The study aimed to investigate the preoperative prevalence, the associated risk factors, and the locations of deep venous thrombosis (DVT) in patients with closed patella fracture. The detailed information on the prevalence, related risk factors, and locations of DVT in isolated lower limb fractures (ILLFs) has not been paid much attention to. There were few kinds of researches focusing on the DVT in ILLFs of different anatomical sites [12,13,14,15], and the incidence rates varied greatly between different locations. The current study was the first study with an adequate size sample focusing on the preoperative DVT in closed patella fractures

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