Risk factors for lower extremity deep vein thrombosis after intertrochanteric fracture of the femur and its response.

Abstract

The aim was to investigate the independent risk factors affecting the formation of lower extremity deep vein thrombosis (DVT) after intertrochanteric fracture of the femur, and to propose corresponding preventive measures. Data were collected from patients who underwent intertrochanteric femur fracture surgery in our hospital during the period from January 2020 to December 2023, and the independent risk factors for the formation of postoperative lower limb DVT were determined by univariate and multivariate logistic regression analyses, which led to the construction of the corresponding Nomogram model. The performance of the model was assessed by plotting the subjects' work characteristic curve and its corresponding area under the curve, as well as calibration curve and decision curve analysis. A total of 627 patients with intertrochanteric femoral fractures were included in the study, of whom 156 had postoperative thrombosis, with an incidence rate of 24.88%. By univariate and multivariate logistic regression analyses, 5 independent risk factors associated with lower extremity DVT formation after intertrochanteric femur fracture were identified, including age >75 years (OR: 1.719; 95% CI: 1.094-4.105), body mass index >24 (OR: 2.190; 95% CI: 1.610-2.899), history of preoperative diabetes mellitus (OR: 1.511; 95% CI: 1.079-2.115), high-energy injury (OR: 4.184; 95% CI: 1.977-8.858), and fracture-to-operation time of more than 48 hours (OR: 2.666; 95% CI: 1.964-4.342). The Nomogram model constructed in this study for DVT formation in the lower limb after femoral intertrochanteric fracture showed high predictive accuracy, which can help orthopedic surgeons to identify high-risk patients and intervene early to reduce the occurrence of postoperative DVT.