Incidence and Risk Factors for Deep Venous Thrombosis of Lower Extremity After Surgical Treatment of Isolated Patella Fractures

Abstract

Background: Limited information exists on the incidence of postoperative deep venous thromboembolism (DVT) in patients with isolated patella fractures. The objective of this study was to investigate the postoperative incidence and locations of deep venous thrombosis (DVT) of the lower extremity in patients underwent isolated patella fractures and to identify the associated risk factors.Methods: We collected the medical data of 716 hospitalized patients with acute isolated patella fracture who presented at the 3rd Hospital of Hebei Medical University between January 1, 2016, and February 31, 2019 and all patients met the inclusion criteria. Medical data were collected using the inpatient record system, including the patient demographics, patient’s bad hobbies, comorbidities, past medical history, fracture and surgery-related factors, and hematological biomarkers, total hospital stay, preoperative stay. Doppler examination was conducted for the diagnosis of DVT, Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors.Results: Among the 716 patients, DVT was confirmed in 29 cases, indicating an incidence of 4.1%. DVT involved bilateral limbs (injured and uninjured) in one patient (3.4%). DVT involved superficial femoral common vein in 1 case (3.4%), popliteal vein in 6 cases (20.7%), posterior tibial vein in 11 cases (37.9%), and peroneal vein in 11 cases (37.9%). The median of the interval between surgery and diagnosis of DVT was 4.0 days (range: 1.0 to 8.0 days). Six variables were identified to be independent risk factors for DVT, including age category (>65 years old), OR, 4.44 (1.34 - 14.71), arrhythmia, OR, 4.41(1.20 - 16.15), intra-operative blood loss, OR, 1.01 (1.00 - 1.02), preoperative stay (delay of each day), OR, 1.43 (1.15 - 1.78). Surgical duration, OR, 1.04 (1.03 - 1.06), LDL-C (> 3.37 mmol/L), OR, 2.98 (1.14 - 7.76).Conclusion: Incidence of postoperative DVT in patients with isolated patella fractures is not low. More attentions should be paid on postoperative DVT prophylaxis in patients with isolated patella fractures. Identification of associated risk factors can help clinicians recognize the risk population, assess the risk of DVT and develop personalized prophylaxis strategies.