Incidence and risk factors of preoperative deep venous thrombosis in closed tibial shaft fracture: a prospective cohort
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Incidence and risk factors of preoperative deep venous thrombosis in closed tibial shaft fracture: a prospective cohort study Jiangtao Ma1,2,3 · Jin Qin1,2,3 · Meishuang Shang1,2,3 · Yali Zhou1,2,3 · Yingze Zhang2,3,4,5 · Yanbin Zhu2,3,4 Received: 21 July 2020 / Accepted: 4 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To investigate the preoperative morbidity of deep venous thrombosis (DVT) and predictive risk factors associated with DVT after closed tibial shaft fracture. Methods Ultrasonography and blood analyses were performed preoperatively in patients who sustained tibial shaft fracture between October 2014 and December 2018. Univariate analyses were used in the data of demographics, comorbidities, mechanism of injury, concomitant fractures and laboratory biomarkers. Multivariate logistic regression analyses were conducted to determine the independent risk factors associated with DVT. Results In total, 918 patients with an operatively treated tibial shaft fracture were included, among whom 122 patients had preoperative DVTs, indicating a crude morbidity of 13.3%. Ninety-two of 758 (12.1%) patients with isolated tibial shaft fracture developed DVT, while 30 of 160 (18.8%) patients with concurrent fracture presented with DVT. The average interval between fracture and initial diagnosis of DVT was 3.1 days (median, 2 days), ranging from 0 to 33 days. Among DVT-positive patients, 16 (13.1%) patients presented with proximal DVT and 106 (86.9%) patients had distal DVT. Multivariate logistic regression analysis showed four independent risk factors were significantly correlated to the development of DVT, including increased age (OR = 1.17, p = 0.003), diabetes (OR = 1.99, p = 0.009), serum hydroxybutyrate dehydrogenase > 182 U/L (OR = 1.83, p = 0.008), and delay to DUS (in each day) (OR = 1.13, p 182 U/L, delay to DUS and older age. Level of evidence Level III, a prospective cohort study. Keywords Deep venous thrombosis · Tibial shaft fractures · Risk factors · Thromboprophylaxis
Jiangtao Ma and Jin Qin contributed equally to this work. * Yingze Zhang [email protected] * Yanbin Zhu [email protected] Jiangtao Ma [email protected] Jin Qin [email protected] Meishuang Shang [email protected] Yali Zhou [email protected]
1
Hebei Orthopedic Clinical Research Center, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, People’s Republic of China
2
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, People’s Republic of China
3
Orthopaedic Institution of Hebei Province, Shijiazhuang 050051, Hebei, People’s Republic of China
4
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, People’s Republic of China
5
Chinese Academy of Engineering, Beijing 100088, People’s Republic of China
13
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Introduction Deep venous thrombosis (DVT) and pulmonary embolism (PE) are principal sources of potentially preventabl
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