Analysis of Risk Factors for Deep Vein Thrombosis in Patients with Perioperative Prophylactic Use of Anticoagulants in Orthopaedics

Chen Quanjin; Lin Dongze; Chen Bin; Wei Xiaojuan

Abstract：Objective To investigate the incidence and influencing factors of deep vein thrombosis(DVT)in orthopaedic patients receiving perioperative anticoagulant prophylaxis.Methods A retrospective study enrolled 8 114 consecutive orthopaedic patients who received standardized perioperative anticoagulant prophylaxis in our hospital between January 2023 and December 2023.Among them,3 739 were male and 4 375 were female,aged 9～100 years[(mean(60.58±16.09)years)].Lower-extremity DVT occurred in 2 116 patients(DVT group)and did not occur in 5 998 patients(non-DVT group),giving an overall incidence of 26.08％.Within the 2 116 DVT cases,62.38％were detected before surgery and 37.62％after surgery;7.14％were proximal DVT,59.17％isolated soleal vein thrombosis,and 33.69％other distal DVT.Under appropriate anticoagulant therapy,complete thrombus resolution was achieved in(6.79±3.69)days for proximal DVT,(7.23±5.86)days for soleal vein thrombosis,and(6.80±4.35)days for other distal DVT.Results Univariate analysis showed significant differences between the DVT and non-DVT groups in age,sex,timing of anticoagulant initiation,anticoagulant type,D-dimer,fibrinogen,injury site and surgical procedure(P＜0.05).Multivariate logistic regression identified age,sex,anticoagulant type,D-dimer,fibrinogen and injury site as independent risk factors for perioperative lower-extremity DVT.Conclusion Despite anticoagulant prophylaxis,DVT incidence in orthopaedic patients remains considerable,with distal DVT predominating.Advanced age,male sex,choice of anticoagulant,elevated D-dimer and fibrinogen,and injury site are independent predictors of DVT in this setting.