Influence of operation mode and operation time on the incidence of postoperative deep venous thrombosis for the aged patients with hip fractures

LI Ming-dong; WANG Dan; GAO Xing; QIN Jun-jun; LIU Jian

doi:10.3969/j.issn.2095-252X.2017.05.011

Abstract：Objective To explore the influence of operation mode and operation time on the incidence of postoperative deep venous thrombosis ( DVT ) for the aged patients with hip fractures. Methods A retrospective analysis of 276 aged patients with hip fractures between July 2010 and December 2015 was carried out, including 140 males and 136 females, whose average age was 73.3 years ( range: 65 - 85 years ). According to the surgical methods, they were divided into 3 groups. There were 100 patients in group A ( closed reduction proximal femoral nail anti-rotation and closed reduction hollow screw internal fixation ), 98 patients in group B ( open reduction proximal femoral locking plate and open reduction hollow screw internal fixation ) and 78 patients in group C ( artificial hip replacement-cementless ). According to the operation time, they were divided into 3 groups. There were 140 patients in group X ( operation time < 60 min ), 90 patients in group Y ( operation time: 60 - 120 min ) and 46 patients in group Z ( operation time > 120 min ). The incidences of postoperative DVT were compared respectively among groups A, B, C and X, Y, Z. Results As to the surgical methods, DVT happened to 2 of 100 patients in group A, and the incidence was 2%. DVT happened to 2 of 98 patients in group B, and the incidence was 2.04%. DVT happened to 9 of 78 patients in group C, and the incidence was 11.54%. The incidence of DVT in group C was higher than those in group A and group B, and there were statistically significant differences ( P = 0.011; P = 0.012 ). As to the operation time, DVT happened to 2 of 140 patients in group X, and the incidence was 1.4%. DVT happened to 3 of 90 patients in group Y, and the incidence was 3.3%. DVT happened to 8 of 46 patients in group Z, and the incidence was 17.4%. The incidence of DVT in group Z was higher than those in group X and group Y, and there were statistically significant differences ( P < 0.001; P = 0.007 ). Conclusions In the aged patients with hip fractures, the higher incidence of DVT will be noticed in the operation with bigger wound than smaller wound. When the operation time is more than 120min, the incidence of DVT will be significantly increased. The formation of DVT cannot be totally avoided with 10mg of rivaroxaban per day after operation, so we should pay attention to comprehensive prevention and screening of DVT after operation.