Incidence and risk factors predicting deep venous thrombosis of lower extremity following spinal fractures

Ma, Jiangtao; Du, Pan; Jin, Qin; Zhou, Yali; Liang, Ningxi; Hu, Jinglve; Zhang, Yingze; Zhu, Yanbin

doi:10.1038/s41598-021-82147-x

Cited by 39 publications

(29 citation statements)

References 33 publications

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“…This phenomenon not only appeared at all postoperative time points, but also the preoperative comparison was significant. Ma et al 30 demonstrated in a study from their institution with 2432 patients with spinal fracture that patients with ASIA A and B had a 2.36-fold increased risk for the occurrence of DVT, which was in concordance with the findings by our previous study. 26 The loss of the motor function can weaken muscle pumps which may cause hypercoagulability and venous stasis.…”

Section: Discussionsupporting

confidence: 91%

The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients with Thoracolumbar Fracture Caused by High-Energy Injuries

Wang

et al. 2022

Clin Appl Thromb Hemost

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Objective To investigate the dynamic variation of D-dimer and to evaluate the efficacy and accuracy of D-dimer level in patients with thoracolumbar fractures caused by high-energy injuries. Methods A total of 121 patients with thoracolumbar fractures caused by high-energy injuries were retrospectively identified and included in this study. There were 83 males and 38 females, with an average age of 48.6 ± 11.2 years. All patients were treated with either screw fixation surgery or decompression fixation surgery. The D-dimer levels were measured 1 day before surgery and on the first, third, and fifth days after surgery. The dynamic variation of D-dimer and the effects of risk factors on D-dimer levels were analysed. A receiver operating characteristic (ROC) curve analysis was performed and the appropriate D-dimer cut-off level was determined for deep vein thrombosis (DVT) screening. Results Due to a trough on the third day, D-dimer levels grew in an unsustainable manner following surgery (P < 0.001). Patients with the operation time >120 min (P = 0.009) and those with an American Spinal Injury Association (ASIA) score A-C (P < 0.001) had higher D-dimer levels. The area under the curve of D-dimer was the greatest on the third day. Applying stratified cut-off values did not change the sensitivity, specificity and negative predictive value in the group with an operation time >120 min, and ASIA score A-C group. Conclusions D-dimer levels elevated with fluctuation in patients with thoracolumbar fractures caused by high-energy injuries after surgery. Both operation time and ASIA score had an impact on D-dimer levels. Regarding DVT diagnoses, the diagnostic value of D-dimer was highest on the third day postoperatively, and stratified cut-off values by these two factors did not show better diagnostic efficacy compared with a collective one.

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Section: Discussionsupporting

confidence: 91%

The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients with Thoracolumbar Fracture Caused by High-Energy Injuries

Wang

et al. 2022

Clin Appl Thromb Hemost

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“…Despite the use of the modern prophylactic regimen, our results indicated a 13.5% incidence of DVT before surgery, with 31.7% of those being proximal veins in origin. In addition to some well-established predisposing factors such as older age or obesity, other risk factors also exhibited independent association with preoperative DVT, which was partially consistent with prior studies on population with fractures [ 18 – 20 ]. However, the consensus on DVT management following pelvic and acetabular fractures has not been reached, largely due to their variations in diagnostic method and prophylactic protocol.…”

Section: Discussionsupporting

confidence: 87%

“…Hypoalbuminemia is adversely associated with complications and prognosis after major orthopaedic surgeries [ 30 , 31 ]. A recent study by Ma et al [ 18 ] found that low albumin level was strongly linked with preoperative DVT in patients undergoing spinal fracture. It was approximately concordant with our findings that patients with a serum albumin less than 32.8 g/L and fibrinogen more than 3.09 g/L had 2.71- and 3.34-time elevated risk of DVT following pelvic and acetabular fractures, respectively.…”

Section: Discussionmentioning

confidence: 99%

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

Zhao

Liu

et al. 2022

J Orthop Surg Res

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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.

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“…In addition, patients with DVT of lower extremities will also have postthromboembolic syndrome (PTS), which can cause long-term pain and blood stasis, affect normal life and working ability, and even lead to disability. It is also the main complication of DVT of lower extremities [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of CDT on Hemodynamics and Quality of Life in a Subgroup of Patients with Lower Limb Deep Vein Thrombosis Carel: A Case-Control Study

Zhang

Yan

2022

Computational and Mathematical Methods in Medicine

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Objective. To explore the effects of combined catheter-directed thrombolysis (CDT) on hemodynamics and quality of life in a subgroup of patients with lower limb deep vein thrombosis carel by using a case-control study. Methods. Eighty-four patients with deep venous thrombosis (DVT: acute DVT and chronic DVT) of lower extremities treated in our hospital from April 2017 to June 2021 were randomly assigned into the control group ( n = 42 ) and the research group ( n = 42 ). The control group only received routine nursing combined with CDT; the research group was treated with cluster nursing l combined with CDT. The clinical efficacy, the difference in limb circumference, hemorheology, hemodynamics, coagulation index and life quality before and after treatment, and the nursing satisfaction scores were calculated. The effects of cluster nursing l combined with CDT on hemodynamics and life quality in patients with DVT of lower extremities were analyzed. Results. The clinical curative effect of the research group was better than that of the control group ( P < 0.05 ). After intervention, the difference in the thigh and leg perimeter in the research group was reduced, and the difference in the thigh and leg perimeter in the research group was significantly lower than that in the control group ( P < 0.05 ). After intervention, the whole blood low shear viscosity, plasma viscosity, platelet aggregation rate, and fibrinogen in the research group were lower than those in the control group ( P < 0.05 ). After intervention, segmental venous volume (SVC), maximum venous blood flow (MVO), and SVC/MVO in the research group were significantly higher than those before intervention, VRT was significantly prolonged, and MVO and venous pressure recovery time (VRT) were significantly higher than those in the control group. After intervention, D-dimer and fibrinogen decreased, prothrombin time and activated partial thromboplastin time increased in the research group, and the improvement of blood coagulation index in the research group was significantly better than that in the control group ( P < 0.05 ). After intervention, the scores of quality of life in the research group decreased, and the scores of physiological function, psychological function, social function, and health self-cognition in the research group were lower than those in the control group ( P < 0.05 ). The satisfaction of patients in the research group was significantly higher than that in the control group ( P < 0.05 ). Conclusion. The application of cluster nursing l combined with CDT can effectively prevent lower limb venous thrombosis after operation and can enhance patients’ hemorheology, hemodynamics, and blood coagulation function and significantly promote their life quality, nursing satisfaction is high, and it is worth popularizing and applying in clinic.

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Incidence and risk factors predicting deep venous thrombosis of lower extremity following spinal fractures

Cited by 39 publications

References 33 publications

The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients with Thoracolumbar Fracture Caused by High-Energy Injuries

The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients with Thoracolumbar Fracture Caused by High-Energy Injuries

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

Effects of CDT on Hemodynamics and Quality of Life in a Subgroup of Patients with Lower Limb Deep Vein Thrombosis Carel: A Case-Control Study

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