Deep Vein Thrombosis in Patients with Intertrochanteric Fracture: A Retrospective Study
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ORIGINAL ARTICLE
Deep Vein Thrombosis in Patients with Intertrochanteric Fracture: A Retrospective Study Chen Fei1,2 · Peng‑Fei Wang1 · Shuang‑Wei Qu1 · Kun Shang1 · Kun Yang1 · Zhi Li1 · Yan Zhuang1 · Bin‑Fei Zhang1 · Kun Zhang1 Received: 12 March 2020 / Accepted: 1 June 2020 © Indian Orthopaedics Association 2020
Abstract Background This study aimed to investigate the incidences of pre- and post-operative lower extremity deep venous thrombosis (DVT) in hospitalized patients with intertrochanteric fractures and to analyze the relevant risk factors. Methods A retrospective study was conducted between July 2014 and October 2016 in 218 intertrochanteric fracture patients who presented at Xi’an Honghui Hospital and underwent Doppler ultrasonography for DVT diagnosis. We divided DVT into distal, proximal, and mixed thrombosis. Patients were divided into either the thrombosis or no thrombosis group according to preoperative and postoperative ultrasonography results. All patients were evaluated for the risk factors associated with thrombosis. Results A total of 37.61% of preoperative patients had DVT, and the postoperative incidence increased to 58.72%. The days between fracture and hospitalization and the days between fracture and surgery were independent risk factors for preoperative DVT. The days between fracture and hospitalization and d-dimer levels at postoperative 1 day were independent risk factors of postoperative DVT. In total 23.4% of the patients progressed from having no thrombosis preoperatively to having distal, proximal, or mixed DVT postoperatively (22.02%, 0.46%, and 0.92%, respectively). Distal DVT constituted 86.59% and 90.63% of all preoperative and postoperative DVTs, respectively. Conclusion Intertrochanteric fracture is a common type of hip fracture in the elderly, and the incidence of DVT after intertrochanteric fracture may be underestimated. Early intervention (early admission and early surgery) might reduce the incidence of DVT. Keywords Deep vein thrombosis · Ultrasonography · Intertrochanteric fracture · Anticoagulation · Low molecular weight heparin Abbreviations ASA American Society of Anesthesiologists BMI Body mass index CRP C-reactive protein
CMVT Calf muscular vein thrombosis DVT Deep vein thrombosis EF External fixation LMWH Low molecular weight heparin
* Bin‑Fei Zhang [email protected]
Kun Yang [email protected]
* Kun Zhang [email protected]
Zhi Li [email protected]
Chen Fei [email protected]
Yan Zhuang [email protected]
Peng‑Fei Wang [email protected]
1
Department of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong University College of Medicine, Beilin District, No. 555 Youyi East Road, Xi’an 710054, Shaanxi, China
2
Xi’an Medical University, Beilin District, Hanguang North Road, Xi’an, Shaanxi, China
Shuang‑Wei Qu [email protected] Kun Shang [email protected]
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Vol.:(0123456789)
ORIF Open reduction internal fixation PE Pulmonary embolism VTE Venous thromboembolism
Background Fractures of the proximal femur (
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