Clinical Observation and Analysis of Incidence, Location and Risk Factors of Deep Vein Thrombosis (DVT) in Lower Extremity after Femoral Neck Fracture in the Elderly
LIU Da-wei,ZHU Yan-bin,WANG Yuchuan
Abstract:
Objective To investigate the incidence, location and risk factors of deep venous thrombosis (DVT) in lower extremity after femoral neck fracture in the elderly. Methods A retrospective analysis was performed on elderly patients with femoral neck fractures admitted to Tianjin Nankai Hospital and the Third Hospital of Hebei Medical University from January 2017 to June 2019.After inclusion and exclusion criteria, a total of 708 patients were included in this study. After admission, we performed routine ultrasound doppler scan on the patients to assess whether the patients had deep vein thrombosis in both lower limbs. Patients with thrombosis were selected as the case group and those without thrombosis as the control group. Clinical data of patients were extracted, including demographic information, comorbidities, injury status and laboratory results on admission, and risk factors associated with DVT were determined by single factor test and binary logistic regression analysis. Results A total of 112 (15.8%) patients were diagnosed with DVT, 84 (75.0%) with distal, 21 (18.8%) with proximal, and 7 (6.2%) with mixed DVT. In 75.9% (85/112) of patients, DVT occurred in the fractured limb, 12.5% (14/112) in the bilateral limb, and 11.6% (13/112) in the non-fractured limb. Multivariate logistic regression analysis showed that age (P<0.05), increased d-dimer (>0.5mg/L) (P<0.05), time from injury to admission (P<0.05), decreased serum albumin level (<35g/L) (P<0.05)and platelet count (>262×109/L) (P<0.05) were independent related factors for the development of DVT in lower extremity. Conclusion The results of this study suggest that the incidence of DVT is higher in the elderly patients with femoral neck fracture upon admission, with proximal DVT reaching 6%.Several related risk factors are independently related to DVT, which can help predict the occurrence of thrombosis,
