Preoperative incidence and risk factors of deep vein thrombosis in patients with an isolated patella fracture

Abstract

Background The purpose of this study was to investigate the incidence, location, and related factors of preoperative deep venous thrombosis (DVT) in patients with isolated patellar fractures. Methods Patients with an isolated patellar fracture, admitted between January 2013 and December 2019 at our institution, were retrospectively analyzed. Upon admission, patients underwent routine Doppler ultrasound scanning (DUS) of the bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Data on demographics, comorbidities, and laboratory test results upon admission were extracted. Differences between the two groups were evaluated using univariate analyses, and independent risk factors associated with DVT were identified by logistic regression analysis. Results During the study window, 827 patients were included, of whom 5.8% (48/827) were found to have preoperative DVT. Among those with DVT, 85.4% (41/48), 8.3 % (4/48), and 6.3% (3/48) occurred in the injured, non-injured, and bilateral lower extremities, respectively. Multivariate analysis showed that age (each increase of 1 year) (odds ratio, OR = 1.02), residential area (OR = 5.00), delay of injury to DUS (in each day, OR = 1.33), and elevated plasma D-dimer level (> 0.5 µg/mL, OR = 2.47) were independent risk factors associated with DVT. Conclusions Despite the low prevalence of DVT after an isolated patellar fracture, this study underscores the importance of identifying those with a high risk of DVT, especially those with multiple identifiable factors, as well as the early targeted use of thromboembolic agents, to reduce DVT occurrence.

Risk factors for deep vein thrombosis after traumatic lower extremity fracture: A systematic review and meta-analysis

“…We excluded another 121 studies based on inclusion and exclusion criteria. Finally, a total of 13 studies [8][9][10][11][12][13][14][15][16][17][18][19][20] were included in this meta-analysis. The literature screening process is shown in Figure 1.…”

“…The 13 included literatures [8][9][10][11][12][13][14][15][16][17][18][19][20] are all original studies. This included 2699 VTE patients and 130,507 normal healthy controls.…”

“…Wahlsten et al [8] 2015 Denmark Cohort 594 57,025 Mantilla et al [9] 2003 USA Case-control 116 Yang [10] 2010 China Case-control 58 Akpinar et al [11] 2013 Turkey Case-control 55 Pedersen et al [12] 2010 Denmark Case-control 1390 66,079 Park et al [13] 2015 Korea Cohort 38 Riou et al [14] 2007 France Case-control 178 Gu [15] 2007 China Case-control 18 Wang [16] 2013 China Case-control 52 Long [17] 2013 China Case-control 73 Tan Z et al [18] 2021 China Case-control 29 Ding K et al [19] 2022 China Case-control 51 Peng J et al [20] 2023 China Case-control 47 traumatic fracture of lower extremity (RR = 1.67, 95% CI: 1.56-1.79), as shown in Figure 5.…”

“…Wahlsten et al [8] 9 Good Good Clarity Good Good Low risk Long Good Mantilla et al [9] 8 Good Good Uncertainty Clarity Good Low risk Long Good Yang [10] 6 Uncertainty Good Clarity Uncertainty Uncertainty Low risk Long Good Akpinar et al [11] 8 Good Good Clarity Clarity Uncertainty Low risk Long Good Pedersen et al [12] 7 Uncertainty Good Clarity Clarity Uncertainty Low risk Long Good Park et al [13] 7 Good Uncertainty Clarity Clarity Good Low risk Long Uncertainty Riou et al [14] 5 Good -Clarity -Uncertainty Low risk Long Uncertainty Gu [15] 6 Good -Clarity -Uncertainty Low risk Long Good Wang [16] 9 Good Good Clarity Clarity Uncertainty Low risk Long Good Long [17] 6 Good -Clarity -Uncertainty Low risk Long Good Tan Z et al [18] 7 Good -Clarity Clarity Uncertainty Low risk Long Good Ding K et al [19] 6 Uncertainty Good Clarity Clarity Uncertainty Low risk Long Good Peng J et al [20] 7 Uncertainty Good Clarity Clarity Uncertainty Low risk Long Good NOS = Newcastle-Ottawa Scale. fractures and LEDVT after fracture, and single-site fractures were protective factors for LEDVT after traumatic fracture (RR = 0.52, 95% CI: 0.39-0.64), as shown in Figure 10.…”