Incidence and risk factors of preoperative deep venous thrombosis following pelvic and acetabular fractures: a retrospective case–control study

Abstract

The objective of this study was to investigate the prevalence of preoperative deep venous thrombosis (DVT) in the pelvic cavity and lower extremities following pelvic and acetabular fractures and to identify the risk factors of the occurrence of DVT. Duplex ultrasound (DUS) screening and blood tests were conducted in patients admitted from June 2012 to December 2020 for surgical treatment of pelvic and acetabular fractures. Univariate analyses were performed on data of demographics, comorbidities, time from injury to surgery, injury mechanism, accompanied injury, and laboratory results. The optimal cutoff values of continuous variables with statistical significance were obtained by using the receiver operating characteristic (ROC) curve. A multivariate logistic regression analysis was then employed to examine the independent values in terms of predicting preoperative DVT. A total of 607 patients with pelvic and acetabular fractures were included, among whom 82 (13.5%) patients sustained preoperative DVTs. Specifically, 31.7% (26/82) were diagnosed with proximal DVTs. Fifty-two (63.4%) patients had DVT within 7 days after injury, and 67 (81.7%) patients within 10 days. The multivariate logistic regression analysis identified 6 factors independently associated with the presence of preoperative DVT, including age > 46 years (odds ratio [OR] = 2.94), BMI > 26.73 kg/m2 (OR = 3.91), time from injury to surgery > 9 days (OR = 5.39), associated injury (OR = 7.85), ALB < 32.8 g/L (OR = 2.71) and FIB > 3.095 g/L (OR = 3.34). Despite the modern prophylactic regimen, the preoperative DVT in patients with pelvic and acetabular fractures still draws the attention of orthopaedic surgeons. Better understanding these risk factors can help surgeons refine the risk stratification profile and perform early interdisciplinary management for patients at high risk of DVT.

MiR-128-3p promotes the progression of deep venous thrombosis through binding SIRT1

“…24 Most patients with DVT have no obvious symptoms, and if there is no in-time therapy, pulmonary embolism will form, which has a high fatality rate. 25 Therefore, it is necessary to investigate biomarkers that are correlated to DVT. The endothelium plays an important role in maintaining normal blood flow and preventing thrombosis formation.…”

Development and validation of a nomogram for predicting deep venous thrombosis in patients with pelvic and acetabular fractures: a retrospective cohort study

“…Occasionally, these fractures can prove to be fatal, particularly when combined with preoperative deep venous thrombosis (DVT). It is reported that the incidence of a thromboembolic event is 13.5-33.7% and even 57.6% in severe traumatic cases [ 3 – 6 ]. To monitor and identify DVT, colour Doppler ultrasound is applied frequently.…”

“…Notably, the nomogram model is a novel and convenient tool and has been widely used to predict outcomes and complications in various diseases [ 7 – 11 ]. To date, several investigations have evaluated the risk factors of venous thromboembolism [ 3 – 5 , 12 , 13 ]. However, none of them developed a nomogram.…”

Trends and treatments of pelvic and acetabular fractures in Taiwan: facing an aging society

“…Similar to hip fractures, pelvic fractures are associated with high hospitalization rates, significant morbidity, and mortality and may lead to serious individual and socioeconomic burdens. Most patients with pelvic fractures die not from the pelvic fracture itself, but from the associated injury and decline in health status [ 2 ]. Pelvic fractures are underestimated osteoporotic or fragility fractures [ 3 ].…”