Chronic kidney disease (lower estimated glomerular filtration rate) was an independent predictor of preoperative DVT, which occurred in 11.7% of middle-aged and elderly patients with hip fractures.
Cohort (n=248)
No
Does chronic kidney disease increase the risk of preoperative deep vein thrombosis in middle-aged and elderly patients with hip fractures?
BACKGROUND: Preoperative deep vein thrombosis (DVT) is a common complication in patients with hip fractures. Chronic kidney disease (CKD) as a frequent comorbidity in middle-aged and elderly patients with hip fractures is known to promote a proinflammatory and prothrombotic state. We aimed to identify whether CKD can increase the risk of DVT in middle-aged and elderly patients with hip fractures, as well as identify other risk factors. PATIENTS AND METHODS: We retrospectively studied 248 middle-aged and elderly patients with hip fractures who were admitted to our hospital from January 2016 to June 2017, meeting all the inclusion criteria. Doppler ultrasonography was used to diagnose DVT. Patients with CKD were classified into five stages according to the Kidney Diseases Outcomes Quality Initiative. We identified whether CKD could increase the occurrence of preoperative DVT in middle-aged and elderly patients with hip fractures and further investigated other independent risk factors for preoperative DVT by using univariate and multivariate analyses. RESULTS: . Briefly, 82.3% (n=204) had been diagnosed with normal kidney function, 11.7% (n=29) with mildly decreased kidney function, and 6.0% (n=15) with stage 3 and 4 CKD. In addition, of the 248 patients, 11.7% (n=29) developed DVT before surgery. Independent predictors of preoperative DVT identified by multivariate analyses were age, prolonged bedridden time, increased levels of fibrinogen, and lower estimated glomerular filtration rate. CONCLUSION: CKD can increase the risk rate of preoperative DVT in middle-aged and elderly patients with hip fractures. Additionally, age, prolonged bedridden time, and increased levels of fibrinogen were also independent risk factors for preoperative DVT in these patients. We should take preventive measures for these patients with risk factors in order to reduce the incidence of preoperative DVT.
Wang et al. (Sat,) は股関節骨折のコホート研究を実施しました（n=248）。手術前の深部静脈血栓症（DVT）について、慢性腎疾患対正常腎機能が評価されました。慢性腎疾患（推定糸球体濾過率の低下）は、手術前のDVTの独立した予測因子であり、股関節骨折の中高年患者において11.7%の症例で発生しました。