Does Venous Thromboembolism Affect Rehabilitation after Hip Fracture Surgery?

Abstract

PurposeVenous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a serious and life-threatening complication in elderly (older than 65 years) patients undergoing hip fracture surgery (HFS). However, few have reported on the influences of VTE on postoperative rehabilitation in these patients. This study was performed to determine whether VTE affects clinical outcomes in patients who underwent HFS.Materials and MethodsWe retrospectively evaluated 330 HFSs in 325 consecutive patients, which were performed from January 2009 to June 2010. From chart review, we identified 15 patients with symptomatic VTE. We compared Geriatric depression scale, Modified Barthel index and Berg balance scale scores as well as 10 meter gait speed at discharge and hospital stay between a symptomatic VTE group and a non-VTE group.ResultsNo significant difference in clinical outcomes at discharge between the two groups was found, although hospital stay was longer in patients with symptomatic VTE (p=0.012).ConclusionEast Asian patients have a low incidence of symptomatic VTE after HFS, and the clinical outcomes of patients with symptomatic VTE were similar to patients without VTE, although there was a longer rehabilitation period.

Recommendations from the ICM-VTE: General

“…The duration of physical therapy between the two groups was similar. But due to the retrospective nature of the study, no information was available about the exact protocol of rehabilitation for the two mentioned groups 2202 .…”

“…Rationale: Patients undergoing orthopaedic surgery are at risk of VTE 2214-2221 . Rehabilitation including early ambulation is of utmost importance to prevent VTE 2222,2223 .…”

Relationship Between the Incidence of Deep Vein Thrombosis During Hospitalization and the Energy of Injury in Tibial Plateau Fractures

“…It is generally believed that high-energy damage can cause a systemic body stress response resulting in a hypercoagulable state and damage to the intima of the blood vessels, thereby increasing the risk of DVT. Previous studies 13,14,[24][25][26] have also shown that high-energy injury can lead to an increased incidence of lower-extremity DVT in patients with pelvicacetabular, hip, and spine fractures. However, our statistical analysis showed no significant differences in preoperative or postoperative DVT between the high-energy group and the low-energy group of patients with TPFs.…”

Comparison of the Surgical Outcome between the Multiple Screw Fixation and Fixed Angle Devices for the Basicervical Femoral Neck Fractures

“…Femoral neck fracture (FNF) has been reported to account for approximately half of all hip fractures, and is one of the most serious fractures, as they are associated with high mortality and morbidity and reduced mobility in elderly patients [1]. Elderly patients with FNF require early surgical intervention to avoid serious medical complications such as pneumonia, pulmonary embolism, deep vein thrombosis, urinary tract infections, and pressure sores [2][3][4]. Closed reduction and internal fixation have been proposed as surgical options for non-displaced FNF [5].…”