A Retrospective Study on the Incidence of Preoperative Deep Vein Thrombosis in Elderly Patients with Hip Fracture

Abstract

Abstract: Objective The purpose of this study was to investigate the incidence of deep vein thrombosis (DVT) in elderly patients with hip fractures before surgery. Methods This retrospective study included 276 elderly patients with hip fracture hospitalized from January 2017 to December 2020. There were 94 males and 182 females with an average age of 77.4 years. There were 178 cases of intertrochanteric fracture and 98 cases of femoral neck fracture. All patients underwent ultrasound to screen for DVT, and 44 patients also underwent lower extremity CT venography.Patients with DVT were given Inferior Vena Cava Filter (IVCF) before surgery. Results None of the patients had signs or symptoms of DVT before surgery. DVT was detected in 38 patients, with a total incidence of 13.8% (38/276). The average time to the emergency room after injury was 31.4 hours. The mean time from hospitalization to surgery was 24.9 hours. The mean time from injury to hospitalization for patients with DVT was 234h, significantly higher than that for patients without DVT (27.4h, P<0.001). Among the patients admitted within 72h, the incidence of DVT was 11.3% (28/248), and among the 28 patients admitted after 72h, DVT occurred in 10 patients (35.7%), with significant statistical difference (P<0.001). Conclusion The preoperative incidence of DVT in elderly patients with hip fracture is relatively low (13.8%), but emphasis on DVT should be considered when admission or surgical delay with greater than 72 hours.

Key words: hip fracture, preoperative thrombus, deep vein thrombosis, delayed hospitalization, delayed surgery

摘要： 目的调查老年髋部骨折患者术前深静脉血栓（DVT）的发生率和影响因素。方法本研究为回顾性研究,纳入2017年1月~2020年12月期间于我院诊治的276名老年髋部骨折患者。男性94例,女性182例,平均年龄77.4岁。股骨粗隆间骨折178例,股骨颈骨折98例。所有患者均行超声检查以筛查DVT,其中44例患者还另外进行了下肢CT静脉造影。DVT患者在手术前置入下腔静脉滤器（IVCF）。结果术前所有患者均无DVT的体征或症状,有38例患者检查出DVT,总发生率为13.8%（38/276）。受伤后到达急诊室的平均时间为31.4h。从住院至手术的平均时间为24.9h。DVT患者从受伤到住院的平均时间为234h,显著高于无DVT患者（27.4h,P<0.001）。72h内入院的患者中DVT发生率为11.3%（28/248）,72h后入院的28例患者中10例发生DVT（35.7%）,有显著统计学差异（P<0.001）。结论老年髋部骨折患者DVT的术前发生率相对较低（13.8%）,但在入院或手术延迟>72h的情况下,应该考虑重点深静脉血栓检查。

关键词: 髋部骨折, 术前血栓, 深静脉血栓, 延迟住院, 延迟手术

CLC Number:

R683

ZHENG Zi-lei, YANG Yan-jiang, LI Hai-ying. A Retrospective Study on the Incidence of Preoperative Deep Vein Thrombosis in Elderly Patients with Hip Fracture[J]. Journal of Chengde Medical University, 2021, 38(5): 392-395.

郑紫磊, 杨延江, 李海英. 老年髋部骨折患者术前深静脉血栓发生率的回顾性研究[J]. 承德医学院学报, 2021, 38(5): 392-395.

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