Exploring risk factors of deep vein thrombosis in the patients before the surgery of pelvic fracture and lower limb fracture
Jiang Jiamei
Feng Qiming
Li Yongxia
Zhu Xiaoguang
Shi Dongcheng
Abstract：Objective To explore the risk factors of deep vein thrombosis(DVT)in the patients before the surgery of pelvic fracture and lower limb fracture.Methods The retrospective cohort study was used to analyze the clinical data of 774 patients hospitalized in the emergency intensive care unit of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2021,and the modified Poisson regression was used to analyze whether the suspected exposure factors were independent risk factors for DVT in the patients before the surgery of pelvic fracture and lower limb fracture.Based on the independent risk factors,the nomogram model was established,and the internal validation was conducted to evaluate its discrimination,calibration,and clinical applicability.Results Among509 patients with pelvic fractures,97 patients(19.057%)had DVT;among 79 patients with pelvic fractures combined with the fractures below the knee joint,21 patients(26.582%)had DVT;among 186 patients with pelvic and femoral fractures,61 patients(32.796%)had DVT.The analysis results showed that pelvic and femoral fractures(ARR=1.619,95%CI 1.223-2.144,P=0.001),emergency abdominal surgery(ARR=1.924,95%CI 1.098-3.372,P=0.022),body mass index(BMI)≥24 kg/m2(ARR=1.382,95%CI 1.072-1.783,P=0.013),injury severity score(ISS)≥25(ARR=1.439,95%CI 1.082-1.913,P=0.012),age range from 40 to 59 years(ARR=1.594,95%CI 1.104-2.300,P=0.013)and age≥60 years(ARR=1.868,95%CI 1.279-2.730,P=0.001)were independent risk factors for DVT in the patients before the surgery of pelvic and lower limb fractures;and the nomogram model expressed certain practical value in predicting DVT risk and determining whether intervention measures should be taken.Conclusions Patients with pelvic and lower limb fractures show the tendency to develop DVT.Pelvic and femoral fractures,emergency abdominal surgery,BMI≥24 kg/m2,ISS≥25,and age≥40 years old are closely related to the occurrence of DVT in the patients before the surgery of pelvic and lower limb fractures.Patients with above-mentioned characteristics should be highly valued and appropriate DVT prevention and treatment measures should be taken in time.
Keywords：Pelvic fractureLower limb fractureDeep vein thrombosisRisk factorRetrospective cohort study
Publication Date：2024-02-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 114-121 )