Deep Vein Thrombosis in Elderly Patients Following Surgery for Fracture of the Proximal Femur

Overview

Journal Malays Orthop J

Specialty Orthopedics

Date 2015 Sep 25

PMID 26401228

Citations 9

Authors

R Magetsari

P Dewo

A S Nugroho

Z Lanodiyu

Affiliations

Soon will be listed here.

Abstract

The incidence of Deep Vein Thrombosis (DVT) is high in orthopaedic cases, associated with morbidity and mortality. This study was done to evaluate the incidence of DVT and factors that contributed to DVT in elderly patients with proximal femur fracture who underwent surgery. Patients 60 years of age and older with proximal femur fracture who underwent surgery were enrolled into this study. Daily observation of the clinical signs of DVT was done post operatively until the subjects were discharged from the hospital. D-Dimer test and contrast venography were carried out on Day 2 and between Days 4 and 7 after surgery. Results were interpreted as normal and obstruction. There were 42 eligible patients, 18 of them (42.86 %) were diagnosed with DVT. We found that positive D-Dimer test (1.40), longer duration of surgery (1.86), and presence of clinical symptoms (1.09) increased the risk of the occurence of thrombosis although not statistically significant. There were four DVT patients who passed away within 4 months after surgery due to complication from DVT. The incidence of DVT in elderly with proximal femur fracture underwent surgery was relatively high (42.86 %) with the mortality rate was 22%.

Citing Articles

Traumatic spine fractures and concomitant venous thromboembolism: A systematic review.

Murtada D, Daher M, Aoun M, Mouawad A, Kreichati G, Kharrat K World Neurosurg X. 2024; 24:100404.

PMID: 39399353 PMC: 11470252. DOI: 10.1016/j.wnsx.2024.100404.

Admission Prevalence and Risk Factors of Deep Vein Thrombosis in Patients with Spinal Cord Injury Complicated with Cervical Fractures.

Lv B, Wang H, Li W, Han G, Liu X, Zhang C Clin Appl Thromb Hemost. 2022; 28:10760296221108969.

PMID: 35763449 PMC: 9247371. DOI: 10.1177/10760296221108969.

Preoperative incidence and risk factors of deep vein thrombosis in patients with an isolated patellar fracture.

Yang W, Wang H, Wei Q, Ding K, Jia Y, Li C BMC Musculoskelet Disord. 2022; 23(1):204.

PMID: 35241054 PMC: 8895776. DOI: 10.1186/s12891-022-05163-6.

Effect of introducing biologics to patients with rheumatoid arthritis on the risk of venous thromboembolism: a nationwide cohort study.

Chen C, Kung P, Chou W, Tsai W Sci Rep. 2021; 11(1):17009.

PMID: 34426637 PMC: 8382764. DOI: 10.1038/s41598-021-96508-z.

Study on the Risk Factors of Preoperative Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture.

Chang W, Wang B, Li Q, Zhang Y, Xie W Clin Appl Thromb Hemost. 2021; 27:10760296211002900.

PMID: 33754840 PMC: 7995307. DOI: 10.1177/10760296211002900.

References

Ishimaru D, Ogawa H, Maeda M, Shimizu K . Outcomes of elderly patients with proximal femoral fractures according to positive criteria for surgical treatment. Orthopedics. 2012; 35(3):e353-8. DOI: 10.3928/01477447-20120222-21. View

Cheng G, Chan C, Liu Y, Choy Y, Wong M, Yeung P . Incidence of Deep Vein Thrombosis in Hospitalized Chinese Medical Patients and the Impact of DVT Prophylaxis. Thrombosis. 2011; 2011:629383. PMC: 3211080. DOI: 10.1155/2011/629383. View

Clagett G, Anderson Jr F, Geerts W, Heit J, Knudson M, Lieberman J . Prevention of venous thromboembolism. Chest. 1998; 114(5 Suppl):531S-560S. DOI: 10.1378/chest.114.5_supplement.531s. View

Kucher N . Clinical practice. Deep-vein thrombosis of the upper extremities. N Engl J Med. 2011; 364(9):861-9. DOI: 10.1056/NEJMcp1008740. View

Wells P, Anderson D, Rodger M, Forgie M, Kearon C, Dreyer J . Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003; 349(13):1227-35. DOI: 10.1056/NEJMoa023153. View

Tovey C, Wyatt S . Diagnosis, investigation, and management of deep vein thrombosis. BMJ. 2003; 326(7400):1180-4. PMC: 1126050. DOI: 10.1136/bmj.326.7400.1180. View

Rossi R, Agnelli G . Current role of venography in the diagnosis of deep-vein thrombosis. Minerva Cardioangiol. 1999; 46(12):507-14. View

Terao M, Ozaki T, Sato T . Diagnosis of deep vein thrombosis after operation for fracture of the proximal femur: comparative study of ultrasonography and venography. J Orthop Sci. 2006; 11(2):146-53. DOI: 10.1007/s00776-005-0997-2. View

Abelseth G, Buckley R, Pineo G, Hull R, Rose M . Incidence of deep-vein thrombosis in patients with fractures of the lower extremity distal to the hip. J Orthop Trauma. 1996; 10(4):230-5. DOI: 10.1097/00005131-199605000-00002. View

10.

Vajanto I, Kuokkanen H, Niskanen R, Haapala J, Korkala O . Complications after treatment of proximal femoral fractures. Ann Chir Gynaecol. 1998; 87(1):49-52. View

11.

Cundiff D . Anticoagulation therapy for venous thromboembolism. MedGenMed. 2004; 6(3):5. PMC: 1435637. View

12.

RABINOV K, Paulin S . Roentgen diagnosis of venous thrombosis in the leg. Arch Surg. 1972; 104(2):134-44. DOI: 10.1001/archsurg.1972.04180020014004. View

13.

Aschwanden M, Labs K, Jeanneret C, Gehrig A, Jaeger K . The value of rapid D-dimer testing combined with structured clinical evaluation for the diagnosis of deep vein thrombosis. J Vasc Surg. 1999; 30(5):929-35. DOI: 10.1016/s0741-5214(99)70019-4. View

14.

Legnani C, Palareti G, Cosmi B, Cini M, Tosetto A, Tripodi A . Different cut-off values of quantitative D-dimer methods to predict the risk of venous thromboembolism recurrence: a post-hoc analysis of the PROLONG study. Haematologica. 2008; 93(6):900-7. DOI: 10.3324/haematol.12320. View

15.

Flinterman L, van Hylckama Vlieg A, Cannegieter S, Rosendaal F . Long-term survival in a large cohort of patients with venous thrombosis: incidence and predictors. PLoS Med. 2012; 9(1):e1001155. PMC: 3254666. DOI: 10.1371/journal.pmed.1001155. View

16.

Sharrock N, Go G, HARPEL P, Ranawat C, Sculco T, Salvati E . The John Charnley Award. Thrombogenesis during total hip arthroplasty. Clin Orthop Relat Res. 1995; (319):16-27. View

17.

Scarvelis D, Wells P . Diagnosis and treatment of deep-vein thrombosis. CMAJ. 2006; 175(9):1087-92. PMC: 1609160. DOI: 10.1503/cmaj.060366. View

18.

Piovella F, Wang C, Lu H, Lee K, Lee L, Lee W . Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Haemost. 2005; 3(12):2664-70. DOI: 10.1111/j.1538-7836.2005.01621.x. View

19.

Adam S, Key N, Greenberg C . D-dimer antigen: current concepts and future prospects. Blood. 2008; 113(13):2878-87. DOI: 10.1182/blood-2008-06-165845. View