Effect of anticoagulation timing on perioperative deep venous thrombosis in elderly patients with hip fracture
10.3760/cma.j.cn115530-20211025-00466
- VernacularTitle:抗凝时机对老年髋部骨折患者围手术期深静脉血栓形成发生率的影响研究
- Author:
Chengcheng ZHANG
1
;
Yao LU
;
Cheng REN
;
Liang SUN
;
Qian WANG
;
Teng MA
;
Ming LI
;
Zhong LI
;
Kun ZHANG
;
Congming ZHANG
;
Yibo XU
;
Qiang HUANG
;
Ning DUAN
;
Hongliang LIU
;
Hanzhong XUE
;
Hua LIN
;
Na YANG
;
Hongfei QI
;
Yu CUI
Author Information
1. 西安交通大学医学院附属红会医院创伤骨科 710054
- Keywords:
Hip fractures;
Venous thrombosis;
Anticoagulation timing;
Prevention;
Aged
- From:
Chinese Journal of Orthopaedic Trauma
2021;23(12):1071-1075
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the influence of anticoagulation timing on incidence of perioperative deep venous thrombosis (DVT) in elderly patients with hip fracture.Methods:A retrospective analysis was made of the 179 elderly patients with hip fracture who had been admitted to Department of Orthopedics and Traumaology, Hong-Hui Hospital from July 2017 to December 2018. They were 78 males and 101 females, aged from 62 to 91 years (mean, 79.5 years). There were 79 femoral neck fractures and 100 intertrochanteric fractures, 109 of which were treated by internal fixation and 70 by hip replacement. The patients were divided into 3 groups depending on the timing of anticoagulation after injury. In group 1 of 74 cases, anticoagulation started <24 h after injury; in group 2 of 36 cases, anticoagulation started 24 to 48 h after injury; in group 3 of 69 cases, anticoagulation started >48 h after injury. Anticoagulation continued until 12 h before surgery in all patients but was resumed 8 to 12 h after surgery. The 3 groups were compared in incidence of perioperative DVT.Results:The 3 groups were comparable due to insignificant differences between them in their pre-operative general data ( P>0.05). DVT occurred perioperatively in 84 patients, yielding an incidence of 46.9% (84/179). The incidences of perioperative DVT were 27.0% (20/74), 47.2% (17/36) and 68.1% (47/69) in groups 1, 2 and 3, respectively, showing significant differences ( χ2=24.206, P<0.001), between any 2 groups ( P<0.05). Conclusion:Since the earlier anticoagulation starts after injury the lower incidence of perioperative DVT in elderly patients with hip fracture, early standardized prophylactic anticoagulation after injury can effectively reduce incidence of perioperative DVT.