Key result
The overall prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures was 20.81%, with longer time from injury to admission significantly increasing the risk (OR 1.342).
Why the study?
Limited studies have investigated the prevalence of preoperative deep vein thrombosis in elderly patients with intertrochanteric fractures.
Observational (n=788)
No
Odds Ratio: 1.342 (95% CI 1.219–1.476)
p-value: p=<0.001
Routine DVT screening before admission is necessary for elderly patients with intertrochanteric fractures due to a high pre-admission prevalence of 20.81%, driven by delayed admission and comorbidities.
High pre-admission DVT prevalence in elderly intertrochanteric fractures was associated with delayed admission; hypothesis-generating for screening, prospective trials needed.
Background Limited studies are available to investigate the prevalence of preoperative deep vein thrombosis (DVT) in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures. Methods This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Cumulative incidence plots were calculated to assess the overall DVT risk and the median time from injury to admission. A stepwise multiple logistic regression analysis was used to identify the risk factors contributing to the occurrence of DVT. Results The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P<0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, atrial fibrillation, varicose veins and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT. Conclusions A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, routine DVT screening before admission was necessary for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.
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Fan et al. (2020) conducted an observational in Intertrochanteric fractures (n=788). Longer time from injury to admission vs. Shorter time from injury to admission was evaluated on Pre-admission deep vein thrombosis (DVT) (OR 1.342, 95% CI 1.219-1.476, p=<0.001). The overall prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures was 20.81%, with longer time from injury to admission significantly increasing the risk (OR 1.342).
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