{"title":"老年髋部骨折患者术前深静脉血栓形成发生率及其危险因素分析。","authors":"Tingming Pan, Dong Zhong, Hongjie Zhang, Jinchao Xu, Jianwei Guan, Xiang Peng","doi":"10.55095/achot2024/062","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of the study: </strong>Hip fractures in the elderly are commonly complicated by deep venous thrombosis (DVT), particularly in the preoperative phase. This retrospective study aimed to determine the preoperative incidence of DVT and identify its risk factors in older patients with hip fractures.</p><p><strong>Material and methods: </strong>This single-center retrospective study enrolled 278 patients (aged ≥ 60 years) with unilateral hip fracture, who underwent color Doppler ultrasonography of the lower extremity veins on the day of surgery at the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine between 1st January 2015 and 31st December 2020. Demographic data, clinical characteristics, and surgical history were analyzed. Multivariate logistic regression was used to identify independent risk factors for preoperative DVT.</p><p><strong>Results: </strong>The incidence of DVT was 15.5%, including peripheral venous thrombosis at 18.6% and central venous thrombosis at 5.4%. Univariate analysis showed no significant differences in gender, age, and type of fracture. However, delayed admission, longer time from admission to surgery, and atrial fibrillation were significant risk factors. Multivariate logistic regression analysis identified delayed admission (OR = 2.597, 95% CI 1.275-5.290, P = .009), prolonged time from admission to surgery (OR = 1.166, 95% CI 1.034-1.314, P = .012), and atrial fibrillation (OR = 2.848, 95% CI 1.115-7.275, P = .029) as significant independent risk factors for DVT.</p><p><strong>Conclusions: </strong>Early admission and prompt surgery of elderly patients with hip fractures are critical to prevent the occurrence of DVT. Atrial fibrillation remains a significant risk factor that requires close attention. Prospective studies are warranted to validate these findings and optimize prophylactic strategies.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"92-97"},"PeriodicalIF":0.4000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Preoperative Incidence of Deep Venous Thrombosis and Its Risk Factors in Older Patients with Hip Fracture].\",\"authors\":\"Tingming Pan, Dong Zhong, Hongjie Zhang, Jinchao Xu, Jianwei Guan, Xiang Peng\",\"doi\":\"10.55095/achot2024/062\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of the study: </strong>Hip fractures in the elderly are commonly complicated by deep venous thrombosis (DVT), particularly in the preoperative phase. This retrospective study aimed to determine the preoperative incidence of DVT and identify its risk factors in older patients with hip fractures.</p><p><strong>Material and methods: </strong>This single-center retrospective study enrolled 278 patients (aged ≥ 60 years) with unilateral hip fracture, who underwent color Doppler ultrasonography of the lower extremity veins on the day of surgery at the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine between 1st January 2015 and 31st December 2020. Demographic data, clinical characteristics, and surgical history were analyzed. Multivariate logistic regression was used to identify independent risk factors for preoperative DVT.</p><p><strong>Results: </strong>The incidence of DVT was 15.5%, including peripheral venous thrombosis at 18.6% and central venous thrombosis at 5.4%. Univariate analysis showed no significant differences in gender, age, and type of fracture. However, delayed admission, longer time from admission to surgery, and atrial fibrillation were significant risk factors. Multivariate logistic regression analysis identified delayed admission (OR = 2.597, 95% CI 1.275-5.290, P = .009), prolonged time from admission to surgery (OR = 1.166, 95% CI 1.034-1.314, P = .012), and atrial fibrillation (OR = 2.848, 95% CI 1.115-7.275, P = .029) as significant independent risk factors for DVT.</p><p><strong>Conclusions: </strong>Early admission and prompt surgery of elderly patients with hip fractures are critical to prevent the occurrence of DVT. Atrial fibrillation remains a significant risk factor that requires close attention. Prospective studies are warranted to validate these findings and optimize prophylactic strategies.</p>\",\"PeriodicalId\":6980,\"journal\":{\"name\":\"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca\",\"volume\":\"92 2\",\"pages\":\"92-97\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.55095/achot2024/062\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.55095/achot2024/062","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
研究目的:老年人髋部骨折通常并发深静脉血栓形成(DVT),尤其是在术前阶段。本回顾性研究旨在确定老年髋部骨折患者术前DVT发生率并确定其危险因素。材料与方法:本单中心回顾性研究纳入278例(年龄≥60岁)单侧髋部骨折患者,于2015年1月1日至2020年12月31日在福建中医药大学附属第二人民医院行下肢静脉彩色多普勒超声检查。分析人口统计学资料、临床特征和手术史。采用多因素logistic回归确定术前DVT的独立危险因素。结果:DVT发生率为15.5%,其中外周静脉血栓形成18.6%,中心静脉血栓形成5.4%。单因素分析显示性别、年龄和骨折类型无显著差异。然而,延迟入院,较长时间从入院到手术,心房颤动是显著的危险因素。多因素logistic回归分析发现,延迟入院(OR = 2.597, 95% CI 1.275-5.290, P = 0.009)、入院至手术时间延长(OR = 1.166, 95% CI 1.034-1.314, P = 0.012)和房颤(OR = 2.848, 95% CI 1.115-7.275, P = 0.029)是DVT的重要独立危险因素。结论:老年髋部骨折患者早期入院,及时手术治疗是预防DVT发生的关键。心房颤动仍然是一个重要的危险因素,需要密切关注。有必要进行前瞻性研究以验证这些发现并优化预防策略。
[Preoperative Incidence of Deep Venous Thrombosis and Its Risk Factors in Older Patients with Hip Fracture].
Purpose of the study: Hip fractures in the elderly are commonly complicated by deep venous thrombosis (DVT), particularly in the preoperative phase. This retrospective study aimed to determine the preoperative incidence of DVT and identify its risk factors in older patients with hip fractures.
Material and methods: This single-center retrospective study enrolled 278 patients (aged ≥ 60 years) with unilateral hip fracture, who underwent color Doppler ultrasonography of the lower extremity veins on the day of surgery at the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine between 1st January 2015 and 31st December 2020. Demographic data, clinical characteristics, and surgical history were analyzed. Multivariate logistic regression was used to identify independent risk factors for preoperative DVT.
Results: The incidence of DVT was 15.5%, including peripheral venous thrombosis at 18.6% and central venous thrombosis at 5.4%. Univariate analysis showed no significant differences in gender, age, and type of fracture. However, delayed admission, longer time from admission to surgery, and atrial fibrillation were significant risk factors. Multivariate logistic regression analysis identified delayed admission (OR = 2.597, 95% CI 1.275-5.290, P = .009), prolonged time from admission to surgery (OR = 1.166, 95% CI 1.034-1.314, P = .012), and atrial fibrillation (OR = 2.848, 95% CI 1.115-7.275, P = .029) as significant independent risk factors for DVT.
Conclusions: Early admission and prompt surgery of elderly patients with hip fractures are critical to prevent the occurrence of DVT. Atrial fibrillation remains a significant risk factor that requires close attention. Prospective studies are warranted to validate these findings and optimize prophylactic strategies.
期刊介绍:
Editorial Board accepts for publication articles, reports from congresses, fellowships, book reviews, reports concerning activities of orthopaedic and other relating specialised societies, reports on anniversaries of outstanding personalities in orthopaedics and announcements of congresses and symposia being prepared. Articles include original papers, case reports and current concepts reviews and recently also instructional lectures.