The incidence and risk factors of deep venous thrombosis in lower extremities following surgically treated femoral shaft fracture: a retrospective case-control study

Autor: Zhi-xin Ren, Yu-fei Yuan, Pengcheng Wang, Yan-Bao Li, Wei Qi
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Deep vein
Diseases of the musculoskeletal system
030204 cardiovascular system & hematology
0302 clinical medicine
Postoperative Complications
Fracture Fixation
Orthopedics and Sports Medicine
030212 general & internal medicine
Orthopedic surgery
Aged
80 and over
Venous Thrombosis
Univariate analysis
Incidence (epidemiology)
Incidence
Middle Aged
Thrombosis
Venous thrombosis
medicine.anatomical_structure
Lower Extremity
Female
Postoperative deep venous thrombosis
Femoral Fractures
Research Article
Adult
medicine.medical_specialty
Adolescent
03 medical and health sciences
Young Adult
medicine
Humans
Femoral shaft fractures
Thromboprophylaxis
Aged
Retrospective Studies
Receiver operating characteristic
business.industry
Case-control study
medicine.disease
Surgery
Logistic Models
RC925-935
Risk factors
ROC Curve
Heart Disease Risk Factors
Case-Control Studies
business
RD701-811
Zdroj: Journal of Orthopaedic Surgery and Research
Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-9 (2021)
ISSN: 1749-799X
Popis: Background There is still a lack of data on deep vein thrombosis (DVT) following surgically treated femoral shaft fracture (FSF). The goal of this study was to investigate the characteristics of postoperative DVT and the association between the occurrence of DVT and risk factors in patients undergoing surgical treatment for FSF. Methods This observational retrospective case-control study reviewed 308 patients who received surgical treatment of FSF between January 2016 and October 2020 at a university hospital. Univariate analyses were performed on the data of demographics, comorbidities, laboratory biomarkers, and operation-related indexes. The receiver operating characteristic (ROC) curve analysis, univariate analyses, and multivariate logistic regression analysis were employed to identify the independent risk factors associated with DVT. Results In total, 308 patients with surgically treated FSF were included, among whom 48 (15.6%) patients had postoperative DVTs. The univariate analyses showing significant differences regarding DVT were American Society of Anesthesiologists (ASA) classification, diabetes mellitus, current smoking, aspartate transaminase (AST), and very-low-density lipoprotein (VLDL) level among the 34 factors. According to the ROC results, the optimal cutoff values for intraoperative blood loss, d-dimer, and age were 350 ml, 1.08 μg/ml, and 35 years, respectively. The multivariable model demonstrated 4 significantly independent associations with postoperative DVT, including current smoking, intraoperative blood loss (> 550 ml), age (> 35 years), and d-dimer > 1.09 μg/ml. Conclusion These risk factors as screening tools contribute to risk stratification of the occurrence of thromboembolic events. In addition, our findings would help orthopedic surgeons make a cross-specialty decision and implement targeted precaution measures for patients with FSF.
Databáze: OpenAIRE
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