Preoperative incidence and locations of deep venous thrombosis (DVT) of lower extremity following ankle fractures

Abstract

This retrospective study aimed to investigate the preoperative incidence and locations of deep venous thrombosis (DVT) in patients undergoing surgeries for ankle fractures and identify the associated risk factors. From January 2016 to June 2019, 1,532 patients undergoing surgery of ankle fractures were included. Their inpatient medical records were inquired for data collection, including demographics, comorbidities, injury-related data and preoperative laboratory biomarkers. DVT of bilateral lower extremities was diagnosed by routine preoperative Doppler examination. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Totally, 98 patients had a preoperative DVT, indicating an incidence rate of 6.4%. A total of 164 clots for 6 veins were found, representing an average of 1.7 for each patient. The detailed DVTs involving veins were as follows: 2 in femoral common vein, 7 in superficial femoral vein, 2 in deep femoral vein, 16 in popliteal vein, 49 in posterior tibial vein, and 88 in peroneal vein. In the multivariate model, 5 risk factors were identified to be associated with DVT, including age (10-year increase), gender, lower ALB level, reduced LYM count and elevated D-dimer level. There was a tendency for diabetes mellitus to increase the risk of DVT, although there was no statistical significance (p = 0.063). These epidemiologic data on DVT may help counsel patients about the risk of DVT, individualized risk assessment and accordingly the risk stratification.

Evaluation of Critical Factors of Postoperative Arrhythmia and Preventive Measures of Deep Venous Thrombosis

“…The occurrence of DVT in the lower limbs is related to intraoperative venous intima injury and blood flow stasis, which increase the level of procoagulant factors and impair the fibrinolytic mechanism [ 37 ]. D-dimer is a fibrin degradation product, and its concentration can be significantly increased in patients with acute thrombosis [ 38 ]. The results of this study suggested that the postoperative D-dimer values of the anticoagulation group and the control group were higher than those before the operation, and the reason is that the surgical trauma increases the body's D-dimer value.…”

Deep vein thrombosis and our treatment applications: 12-year results

“…While the calf vein is the most common DVT, only 15-20 % of the cases have proximal spread. The left lower extremity suffers from disease more often than the right [25,26]. Demir et al in the cases they followed up, the left lower extremity was determined as the most common location of DVT (59,6%) [20].…”

Development and validation of a predictive nomogram for preoperative deep vein thrombosis (DVT) in isolated calcaneal fracture

“…Furthermore, none of these thrombus prediction models is specific to trauma fields, not to mention the various fracture types on basis of locations, degree of displacement, comminution, and extent of involvement. Currently, there have been several studies on the identification of the risk factors for DVTs after foot and ankle trauma 3 , 7 , but they failed to translate the findings into practical DVT risk scales or predictive models. Indeed, in clinical practice, the role of these identified factors seem not to catch sufficient attention from clinicians, mainly due to that they were viewed in isolation.…”