Incidence and risk factors of preoperative deep venous thrombosis following hip fracture: a retrospective analysis of 293 consecutive patients

Abstract

Purpose: This study investigated the incidence and risk factors of preoperative deep venous thrombosis (DVT) after an acute hip fracture.

Methods: We searched the electronic medical record system at our hospital for patients who received treatment for femoral neck (FN), intertrochanteric (IT), or subtrochanteric (ST) fractures between January 1, 2016, and December 31, 2020. DVT was diagnosed using venous compression ultrasonography. Univariate and multivariate regression analyses were performed to identify risk factors for preoperative DVT.

Results: Out of 512 consecutively admitted patients with hip fracture, 293 (median age, 77 years; 174 females) were included in the final analysis after application of the exclusion criteria. There were 162 FN, 122 IT, and 9 ST fractures. Preoperative DVT occurred in 58 patients. Patients over 80 years of age had a significantly higher incidence of preoperative DVT than those aged < 65 years (P = 0.014). Preoperative DVT incidence following extracapsular fracture was significantly higher than that after intracapsular fracture (27.5% versus 13.6%, P = 0.003). Multivariate regression analysis revealed that advanced age (odds ratio [OR] 1.027, P = 0.026) and extracapsular fracture (OR = 2.149, P = 0.013) were associated with a significantly higher risk of preoperative DVT development. While the serum D-dimer level was abnormally elevated in 99% of the patients, this was not a significant factor in the final multivariate analysis (P = 0.562).

Conclusion: The incidence of preoperative DVT after acute hip fracture in this Chinese cohort was approximately 20%. Increased age and extracapsular fracture were independent risk factors for preoperative DVT following acute hip fracture.

Keywords: Deep venous thrombosis; Extracapsular fracture; Hip fractures; Retrospective study; Risk factor.