Extracapsular hip fractures are more prone to perioperative thrombosis than intracapsular hip fractures in elderly patients undergoing arthroplasty for hip fractures: a retrospective cohort study.

Purpose: Whether fracture site has any effect on perioperative deep vein thrombosis (DVT) in elderly patients with hip fractures undergoing arthroplasty is still controversial. This study aimed to evaluate the association between fracture site and perioperative DVT in elderly patients undergoing hip arthroplasty.

Methods: A retrospective cohort analysis was conducted on elderly hip fracture patients who underwent hip arthroplasty and were admitted between January 2015 and December 2021. Patient data, including demographics, comorbidities, injury-related information, laboratory test results at admission, and surgery-related information, were collected. Univariate and multivariate regression analyses, along with subgroup analyses and sensitive analysis, were performed to identify the association between fracture site and DVT.

Results: The study included 593 patients, consisting of 353 patients with intracapsular hip fractures (ICF) and 240 patients with extracapsular hip fractures (ECF), with an average age of 80.7 ± 7.6. The incidence of DVT diagnosed by ultrasonography was 16.9% in all patients. The prevalence of DVT for ECF patients and ICF patients was 22.5% and 13.0%, respectively. In all adjusted multivariate regression analysis model, ECF patients exhibited an increased risk of DVT compared to ICF patients (OR 2.03; 95% CI 1.19-3.47, p = 0.009). Subgroup analyses revealed that female patients with ECF had a higher likelihood of DVT than those with ICF (OR 2.25; 95% CI 1.22-4.13), as did patients aged 65 to 80 years (OR 4.06; 95% CI 1.44-11.41), patients with hemoglobin levels above 110 g/L (OR 2.30; 95% CI 1.08-4.92), and patients with albumin levels above 35 g/L (OR 2.47; 95% CI 1.29-4.73). Sensitivity analysis found similar results.

Conclusion: The findings indicate a significant association between fracture site and perioperative DVT in elderly hip fracture patients undergoing hip arthroplasty, with ECF patients demonstrating a higher likelihood of developing DVT than ICF patients.