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Wu L, Cheng B. A nomogram to predict postoperative deep vein thrombosis in patients with femoral fracture: a retrospective study. J Orthop Surg Res 2023; 18:463. [PMID: 37370139 DOI: 10.1186/s13018-023-03931-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The implementation of more active anticoagulant prevention and treatment measures has indeed led to a significant reduction in the incidence of perioperative deep vein thrombosis (DVT) among patients with bone trauma. However, it is important to note that despite these efforts, the incidence of DVT still remains relatively high. According to the Caprini score, all patients undergoing major orthopedic surgery were defined as the high-risk group for DVT. Stratifying the risk further within high-risk groups for DVT continues to present challenges. As a result, the commonly used Caprini score during the perioperative period is not applicable to orthopedic patients. We attempt to establish a specialized model to predict postoperative DVT risk in patients with femoral fracture. METHODS We collected the clinical data of 513 patients undergoing femoral fracture surgery in our hospital from May 2018 to December 2019. According to the independent risk factors of DVT obtained by univariate and multivariate logistic regression analysis, the corresponding nomogram model was established and verified internally. The discriminative capacity of nomogram was evaluated by receiver operating characteristic (ROC) curve and area under the curve (AUC). The calibration curve used to verify model consistency was the fitted line between predicted and actual incidences. The clinical validity of the nomogram model was assessed using decision curve analysis (DCA) which could quantify the net benefit of different risk threshold probabilities. Bootstrap method was applied to the internal validation of the nomogram model. Furthermore, a comparison was made between the Caprini score and the developed nomogram model. RESULTS The Caprini scores of subjects ranged from 5 to 17 points. The incidence of DVT was not positively correlated with the Caprini score. The predictors of the nomogram model included 10 risk factors such as age, hypoalbuminemia, multiple trauma, perioperative red blood cell infusion, etc. Compared with the Caprini scale (AUC = 0.571, 95% CI 0.479-0.623), the calibration accuracy and identification ability of nomogram were higher (AUC = 0.865,95% CI 0.780-0.935). The decision curve analysis (DCA) indicated the clinical effectiveness of nomogram was higher than the Caprini score. CONCLUSIONS The nomogram was established to effectively predict postoperative DVT in patients with femoral fracture. To further reduce the incidence, more specialized risk assessment models for DVT should take into account the unique risk factors and characteristics associated with specific patient populations.
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Affiliation(s)
- Linqin Wu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Cheng
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Li F, Wei C, Huo S, Liu X, Du J. Predictors of deep-vein thrombosis for acute stroke at admission to a rehabilitation unit: A retrospective study. Front Neurol 2023; 14:1137485. [PMID: 37064195 PMCID: PMC10102505 DOI: 10.3389/fneur.2023.1137485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundDeep-vein thrombosis (DVT) is a common complication of acute stroke (AS). Only limited studies have discussed DVT in patients with AS at admission to a rehabilitation unit. The purpose of this study is to identify the predictors of DVT in AS patients admitted to a rehabilitation unit in China.MethodsWe retrospectively reviewed the medical records of all patients with AS admitted within 14 days of stroke onset between July 2019 and June 2022 at the Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, China. Ultrasonography was used to diagnose DVT in all patients within 3 days after rehabilitation admission. Univariate and binary logistic regression analyses were performed to determine the risk factors for DVT.ResultsOverall, 234 cases were identified and the incidence rate of DVT among AS patients was 13.2% (31/234). The univariate analysis showed that age, drinking, lower limb muscle strength, Brunnstrom Assessment (BRS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), Barthel Index (BI) scale, serum albumin (Alb), and D-dimer were statistically significant factors. Age (OR = 1.037, 95% CI = 1.000–1.075, p < 0.05), BBS (OR = 0.952, 95% CI = 0.913–0.993, p < 0.05), and D-dimer (OR = 1.446, 95% CI = 1.130–1.849, p < 0.05) were demonstrated as independent risk factors for DVT.ConclusionOlder age, lower BBS, and higher D-dimer levels at rehabilitation admission were independent risk factors for DVT. Therefore, ultrasonography should be performed for those patients with these three significant factors before implementing rehabilitation therapy.
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Affiliation(s)
- Fang Li
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Changkun Wei
- School of Mathematics and Statistics, Beijing Jiaotong University, Beijing, China
| | - Su Huo
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiuzhen Liu
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jubao Du
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- *Correspondence: Jubao Du
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Kim CH, Lim EJ, Lee J. Clinical Outcomes following Primary Hip Replacement Arthroplasties in Patients with Solid Organ Transplantation: A Systematic Review and Meta-Analysis. Hip Pelvis 2022; 34:127-139. [PMID: 36299470 PMCID: PMC9577304 DOI: 10.5371/hp.2022.34.3.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/29/2022] [Accepted: 06/18/2022] [Indexed: 11/24/2022] Open
Abstract
There is still controversy regarding clinical outcomes following primary hip arthroplasty after solid organ transplantation (SOT). The aim of this study was to determine whether clinical outcomes after hip arthroplasty differ between previous SOT recipients and control subjects with no history of undergoing SOT. We conducted a systematic search of MEDLINE, Embase, and the Cochrane Library for studies comparing the clinical outcomes after hip arthroplasty following SOT published up to January 5, 2022. A comparison of medical and surgery-related complications, as well as the readmission rate and 90-day mortality rate between previous SOT recipients and control subjects was performed. Subgroup analyses of the SOT types, liver transplantation (LT) and kidney transplantation (KT), were also performed. Ten studies that included 3,631,861 cases of primary hip arthroplasty were included; among these, 14,996 patients had previously undergone SOT and 3,616,865 patients had not. Significantly higher incidences of cardiac complications, pneumonia, and acute kidney injury were observed in the SOT group compared with the control group. Regarding surgical complications, a higher transfusion rate was observed in the SOT group. The readmission rate and 90-day mortality rate were also significantly higher in the SOT group. A significantly higher incidence of deep vein thrombosis was observed in the KT subgroup compared with the control group. A higher risk of medical and surgical complications, as well as higher readmission and mortality rates after hip arthroplasty was observed for previous SOT recipients compared to patients with no history of SOT.
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Affiliation(s)
- Chul-Ho Kim
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Eic Ju Lim
- Department of Orthopedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jeuk Lee
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Wang G, Zhao W, Zhao Z, Wang D, Wang D, Bai R, Hou B, Ren H. Leukocyte as an Independent Predictor of Lower-Extremity Deep Venous Thrombosis in Elderly Patients With Primary Intracerebral Hemorrhage. Front Neurol 2022; 13:899849. [PMID: 35903126 PMCID: PMC9314880 DOI: 10.3389/fneur.2022.899849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Due to the interaction of leukocytes with platelets and coagulation factors, they may in turn play a role in hemostasis or the formation of thrombi. This study aimed to investigate the association of leukocytosis on admission with an increased risk of acute lower-extremity deep venous thrombosis (LEDVT) in elderly patients with primary intracerebral hemorrhage (ICH). Methods This was a single-center, retrospective observational study of consecutive patients observed with spontaneous ICH aged 60 years or above at Lanzhou University Second Hospital from January 2017 to September 2021. Clinical data and demographic information were collected and analyzed. Univariate and multivariate analyses were conducted to identify independent risk factors of acute LEDVT. One-to-one matching was implemented to balance important patient characteristics by the groups' propensity score matching (PSM) analysis. Results A total of 371 elderly patients with primary ICH fulfilled requirements for inclusion and exclusion, of whom 33 (8.89%) experienced LEDVT. Leukocyte counts were statistically higher in the LEDVT group compared to the non-LEDVT group [12.89 (8.80–14.61) × 109 cells/L vs. 8.31 (6.60–10.75) × 109 cells /L, p < 0.001]. Multivariate logistic regression models adjusted for several potential confounding factors were performed, and leukocytes were consistently a significant independent predictor of LEDVT. The optimal cut-off value of leukocyte counts calculated from the receiver operating characteristic (ROC) curve to predict LEDVT was 10.22 × 109 cells /L (area under the curve:0.714, 95%CI 0.665–0.759; the sensitivity was 72.73%; the specificity was 71.01%) in elderly patients with primary ICH. After one-to-one PSM, compared to the matched non-LEDVT group, the matched LEDVT group had significantly higher leukocyte counts [11.98 (8.40–13.94) × 109 cells/L vs. 6.12 (4.68–12.00) × 109 cells/L, p = 0.003]. After PSM, the ROC curve was plotted for leukocytes as a predictor of LEDVT, with an AUC of 0.722 (95%CI 0.593–0.828, p = 0.001; the sensitivity was 87.10%, and the specificity was 61.29%). Elevated leukocytes remained independently significant as predictors of LEDVT in elderly patients with primary ICH. Conclusion Leukocyte at admission is an independent risk factor of LEDVT in elderly patients with primary ICH.
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Affiliation(s)
- Gang Wang
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
| | - Wenjun Zhao
- Department of Health Management Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhiyong Zhao
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
| | - Dengfeng Wang
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
| | - Dong Wang
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
| | - Ruobing Bai
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
| | - Boru Hou
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
- *Correspondence: Boru Hou
| | - Haijun Ren
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
- Key Laboratory of Neurology of Gansu Province, Lanzhou, China
- Haijun Ren
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Liu Z, Liu D, Guo ZN, Jin H, Sun T, Ni C, Yan X. Incidence and Risk Factors of Lower-Extremity Deep Vein Thrombosis After Thrombolysis Among Patients with Acute Ischemic Stroke. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2021; 14:1107-1114. [PMID: 34511981 PMCID: PMC8427686 DOI: 10.2147/pgpm.s321084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/15/2021] [Indexed: 11/25/2022]
Abstract
Background Deep vein thrombosis (DVT) is common among patients with stroke. However, the incidence of DVT in acute ischemic stroke patients treated with thrombolytic therapy and the risk factors associated with this condition are unknown. Objective This study aimed to investigate the incidence and risk factors of DVT after thrombolysis in patients with acute ischemic stroke. Settings and Methods We retrospectively reviewed the medical records of all patients with acute ischemic stroke who underwent ultrasonic examination after intravenous thrombolysis between April 2017 and December 2019 at the stroke center of the First Hospital of Jilin University, China. Color duplex ultrasound was used to diagnosis DVT in all patients within 72 h after intravenous thrombolysis. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for DVT. Results Overall, 474 patients were included in the study. Of these, 75 (15.8%) developed DVT (95% confidence interval 12.5–19.1). Older age was the risk factor that most significantly affected the development of DVT (p = 0.001). Compared to patients younger than 60 years old, those aged 60–69 years and ≥70 years had a higher risk of DVT, at rates of 2.201 (95% CI: 1.033–4.689; p < 0.05) and 4.241 (95% CI: 2.016–8.922; p < 0.001) times higher, respectively. Patients with higher triglyceride levels (odds ratio 0.545, 95% CI: 0.372–0.799, p = 0.002) and longer activated partial thromboplastin time (OR 0.927, 95% CI: 0.862–0.996, p = 0.040) were less likely to have DVT. Conclusion DVT is a common complication among patients undergoing intravenous thrombolysis after acute ischemic stroke. Advanced age may increase the occurrence of DVT to some extent. For these patients, safe antiplatelet therapy should be explored and implemented as soon as possible.
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Affiliation(s)
- Zhuo Liu
- Fourth Military Medical University, School of Nursing, Xi'an, People's Republic of China.,Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Dandan Liu
- Physical Examination Center, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Zhen-Ni Guo
- Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Hang Jin
- Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Tong Sun
- Cadre Ward, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Chunping Ni
- Fourth Military Medical University, School of Nursing, Xi'an, People's Republic of China
| | - Xiuli Yan
- Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China
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Cheng C, Yan Y, Zhang Q, Guo W. Effect of chronic kidney disease on total knee arthroplasty outcomes: a meta-analysis of matched control studies. ARTHROPLASTY 2021; 3:21. [PMID: 35236487 PMCID: PMC8796397 DOI: 10.1186/s42836-021-00078-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose The purpose of this meta-analysis was to review the current evidence in the literature to find out whether the coexisting chronic kidney disease affected infection, revision, transfusion, readmission, mortality, and the length of hospital stay after total knee arthroplasty. Methods Medline, PubMed, Embase, and the Cochrane Library were searched from their dates of inception to June 30, 2020. The primary outcomes were postoperative infection, revision, and mortality. The secondary outcomes were transfusion, the length of hospital stay, and readmission. A P value of < 0.05 was deemed to be statistically significant. Results A total of 881 articles were identified, and 7 articles that met the inclusion criteria were identified to be eligible. The most important finding of our study was that the chronic kidney disease was associated with increased postoperative transfusion (P < 0.05) and mortality (P < 0.05). Meanwhile, the patients with chronic kidney disease were associated with a higher readmission rate, compared to the patients without chronic kidney disease (P < 0.05). However, chronic kidney disease was not associated with high risks for infection (P > 0.05), revision surgeries (P > 0.05), and a prolonged hospital stay (P > 0.05). Conclusions After total knee arthroplasty, the patients with coexisting chronic kidney disease carry higher risks of transfusion, mortality, and readmission. However, the chronic kidney disease may not be associated with the risk of infection or revision, nor the duration of hospitalization.
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Affiliation(s)
- Chongjie Cheng
- Graduate School of Peking Union Medical College, Beijing, China.,China-Japan Friendship Institute of Clinical Medicine, Beijing, China.,Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Yan Yan
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China.,Peking University China-Japan, Friendship Institute of Clinical Medicine, Beijing, China
| | - Qidong Zhang
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Wanshou Guo
- Graduate School of Peking Union Medical College, Beijing, China. .,China-Japan Friendship Institute of Clinical Medicine, Beijing, China. .,Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China.
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Impact of chronic kidney disease on outcomes after total joint arthroplasty: a meta-analysis and systematic review. INTERNATIONAL ORTHOPAEDICS 2019; 44:215-229. [DOI: 10.1007/s00264-019-04437-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
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You Y, Zhang Y, Qiang L, Sun Y, Zhang J, Bou E, Yan M, Dai K, Ding M. Prevalence and risk factors for perioperative complications of CKD patients undergoing elective hip surgery. J Orthop Surg Res 2019; 14:82. [PMID: 30894199 PMCID: PMC6425709 DOI: 10.1186/s13018-019-1118-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/06/2019] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Chronic kidney disease (CKD) is known to increase morbidity and mortality after orthopedic surgery. The purpose of this study is to investigate how CKD affects perioperative complications in hip surgery patients. MATERIAL AND METHODS From 2013 to 2016, a total of 230 patients (30 patients with CKD and 200 without CKD) undergoing hip surgery were enrolled in this study. Preoperative, intraoperative, and postoperative data was collected and analyzed between CKD and non-CKD patients. Logistic regression was used to evaluate the independent risk factor for postoperative complications. RESULTS There were significant differences in the number of people with hypertension (90.0% vs 27.3%, P < 0.001), diabetes (33.3% vs 8.7%, P = 0.01), coronary heart disease (20.0% vs 2.0%, P = 0.001), smoking habits (56.7% vs 22.7%, P = 0.016), anemia (90.0% vs 19.3%, P < 0.001), and low hemoglobin levels (94.1 ± 19.7 vs 121.3 ± 18.8, P < 0.001) between CKD and non-CKD patients before surgery. Receiving a blood transfusion was significantly more common in CKD patients (50% vs 28.5%, P = 0.018). Postoperatively, significant differences were detected in the average number of patients who transferred to the ICU (73.3% vs 19.3%, P < 0.001). Furthermore, differences were found in the quantity of hemoglobin (92.5 ± 16.8 vs 107.5 ± 18.3, P < 0.001) and albumin (32.4 ± 4.1 vs 34.9 ± 5.5, P = 0.02) measured between CKD and non-CKD patients. Logistic regression analysis indicated that diabetes, alcohol, and anemia were all independent risk factors for obtaining a blood transfusion, while age, CKD, and osteoporosis were all independent risk factors for ICU transfers. CONCLUSION Compared with non-CKD patients, CKD patients were accompanied with more cardiac diseases preoperatively. In addition, CKD patients were more likely to receive a blood transfusion and transfer to the ICU after hip surgery. Preoperative anemia should be restored sufficiently to decrease the incidence of blood transfusions.
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Affiliation(s)
- Yongqing You
- Department of Nephrology, Affiliated Hospital of Nanjing Medical University, North District of Suzhou Municipal Hospital, Suzhou, China.
| | - Yijian Zhang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Lei Qiang
- Southwest Jiaotong University College of Medicine, 610031, No.111, North Section,2nd Ring Road, Chengdu, Sichuan, China.,Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ye Sun
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Junxin Zhang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Emily Bou
- Biochemistry Department, University of Waterloo, Waterloo, Canada
| | - Moqi Yan
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Kerong Dai
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Muliang Ding
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
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Wang Z, Xiao J, Zhang Z, Qiu X, Chen Y. Chronic kidney disease can increase the risk of preoperative deep vein thrombosis in middle-aged and elderly patients with hip fractures. Clin Interv Aging 2018; 13:1669-1674. [PMID: 30237703 PMCID: PMC6138966 DOI: 10.2147/cia.s174691] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Preoperative deep vein thrombosis (DVT) is a common complication in patients with hip fractures. Chronic kidney disease (CKD) as a frequent comorbidity in middle-aged and elderly patients with hip fractures is known to promote a proinflammatory and prothrombotic state. We aimed to identify whether CKD can increase the risk of DVT in middle-aged and elderly patients with hip fractures, as well as identify other risk factors. Patients and methods We retrospectively studied 248 middle-aged and elderly patients with hip fractures who were admitted to our hospital from January 2016 to June 2017, meeting all the inclusion criteria. Doppler ultrasonography was used to diagnose DVT. Patients with CKD were classified into five stages according to the Kidney Diseases Outcomes Quality Initiative. We identified whether CKD could increase the occurrence of preoperative DVT in middle-aged and elderly patients with hip fractures and further investigated other independent risk factors for preoperative DVT by using univariate and multivariate analyses. Results The mean estimated glomerular filtration rate was 125.7±41.4 mL/min/1.73 m2. Briefly, 82.3% (n=204) had been diagnosed with normal kidney function, 11.7% (n=29) with mildly decreased kidney function, and 6.0% (n=15) with stage 3 and 4 CKD. In addition, of the 248 patients, 11.7% (n=29) developed DVT before surgery. Independent predictors of preoperative DVT identified by multivariate analyses were age, prolonged bedridden time, increased levels of fibrinogen, and lower estimated glomerular filtration rate. Conclusion CKD can increase the risk rate of preoperative DVT in middle-aged and elderly patients with hip fractures. Additionally, age, prolonged bedridden time, and increased levels of fibrinogen were also independent risk factors for preoperative DVT in these patients. We should take preventive measures for these patients with risk factors in order to reduce the incidence of preoperative DVT.
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Affiliation(s)
- Zhen Wang
- Department of Orthopedics, Drum Tower Hospital Clinical College of Nanjing University, Nanjing, China,
| | - Ji Xiao
- Department of Orthopedics, Drum Tower Hospital Clinical College of Nanjing University, Nanjing, China,
| | - Zitao Zhang
- Department of Orthopedics, Drum Tower Hospital Clinical College of Nanjing University, Nanjing, China,
| | - Xusheng Qiu
- Department of Orthopedics, Drum Tower Hospital Clinical College of Nanjing University, Nanjing, China,
| | - Yixin Chen
- Department of Orthopedics, Drum Tower Hospital Clinical College of Nanjing University, Nanjing, China,
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