The purpose of this prospective study was to investigate the pre-operative incidence of and risk factors for deep venous thrombosis (DVT) in geriatric intertrochanteric fractures to help facilitate the peri-operative management of them.
Materials and methods
Data of 1515 geriatric intertrochanteric fracture patients were extracted from a prospective intertrochanteric fractures database according to the inclusion criteria and exclusion criteria. The demographics, fracture characteristics, and pre-operative laboratory indicators of patients were evaluated statistically.
The incidence of pre-operative DVT was 10.2% (155 in 1360 patients) in the present study. The rates of proximal DVT, distal DVT, and mixed DVT were 18.1% (28 patients), 56.8% (88 patients), and 25.2% (39 patients), respectively. The percentages of DVT developing in the affected limb, uninjured limb, and bilateral limbs were 74.2% (115 in 55 patients), 16.8% (26 in 155 patients), and 9% (14 in 155 patients), respectively. After the multivariable analysis, the time from injury to surgery (TIS) > 4 days [odds ratio (OR) = 1.870, p = 0.001], the number of comorbidities > 2 (OR = 2.124, p = 0.014), and albumin (ALB) < 35 g/L (OR = 1.516, p = 0.043), etc. were significantly associated with the development of preoperative DVT in geriatric intertrochanteric fracture patients.
Although routine anticoagulant therapy was used to prevent the formation of DVT, the incidence of which was still high. Therefore, pre-operative ultrasound of both lower extremities was advised for pre-operatively, especially for patients with delayed surgery, hypoproteinemia, three or more comorbidities, and a d-dimer level > 1.59 mg/L.
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The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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The study was funded by National Key R&D Program of China (Grant No.2019YFC0120600).
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This study was approved by the ethics committee of Third Hospital of Hebei Medical University, and all the participants had written informed consent.
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Zhao, K., Wang, Z., Tian, S. et al. Incidence of and risk factors for pre-operative deep venous thrombosis in geriatric intertrochanteric fracture patients. International Orthopaedics (SICOT) (2021). https://doi.org/10.1007/s00264-021-05215-x
- Hip fracture
- Pre-operative interval
- Medical comorbidities