scholarly journals Clinical predictors for deep vein thrombosis on admission in patients with intertrochanteric fractures: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jixing Fan ◽  
Fang Zhou ◽  
Xiangyu Xu ◽  
Zhishan Zhang ◽  
Yun Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Univariate Analysis ◽  
High Energy ◽  
Intertrochanteric Fractures ◽  
Multivariate Logistic Regression ◽  
Vein Thrombosis ◽  
High Prevalence ◽  
Deep Vein ◽  
Time From Injury

Abstract Background Limited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures. Methods This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Univariate analysis and stepwise backward multivariate logistic regression were used to identify the risk factors contributing to the occurrence of DVT. Results The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). The mean time from injury to admission was 2.1 days in the total population, 2.96 and 1.87 days in patients with and without DVT. Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, lower Hb value, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P < 0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, lower Hb, diabetes and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT. Conclusions A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, surgeons should be aware of the high prevalence of DVT for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.

scholarly journals Clinical Predictors for Deep Vein Thrombosis on Admission in Patients with Intertrochanteric Fractures: A Retrospective Study

2020 ◽  
Author(s):  
Jixing Fan ◽  
Fang Zhou ◽  
Xiangyu Xu ◽  
Zhishan Zhang ◽  
Yun Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Varicose Veins ◽  
High Energy ◽  
Intertrochanteric Fractures ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Time From Injury

Abstract Background Limited studies are available to investigate the prevalence of preoperative deep vein thrombosis (DVT) in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures.Methods This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Cumulative incidence plots were calculated to assess the overall DVT risk and the median time from injury to admission. A stepwise multiple logistic regression analysis was used to identify the risk factors contributing to the occurrence of DVT.Results The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P<0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, atrial fibrillation, varicose veins and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT.Conclusions A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, routine DVT screening before admission was necessary for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.

scholarly journals Risk and Protective Factors Analysis for Postoperative Delirium in Elderly Critically Ill Patients: A Multicenter Retrospective Study

2020 ◽  
Author(s):  
Shunpeng Xing ◽  
Shaolin Ma ◽  
Yuxi Zhou ◽  
Ming Lei ◽  
Gang Feng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Postoperative Delirium ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Postoperative Hypertension

Abstract Objective: To study the incidence and risk factors of postoperative clinical delirium in critically ill elderly patients in order to devise strategies for prevention and treatment.Methods: We collected clinical data from 451 critically ill patients in the intensive care unit from four hospitals in Shanghai Pudong New Area. Postoperative delirium was measured using the Confusion Assessment Method for the ICU (CAM-ICU), and then the incidence of postoperative delirium was calculated. We used univariate analysis and multivariate logistic regression analysis to determine the risk factors associated with postoperative delirium in critically ill elderly patients.Results: Among the 451 critically ill patients, 56 had delirium after operation. The incidence of postoperative delirium was 12.4%. Univariate analysis showed that the incidence of postoperative delirium was significantly higher (P <0.05) in patients who had a past history of chronic obstructive pulmonary disease (COPD), underwent emergency surgery, were not administered intraoperative Propofol, had postoperative hypertension, were administered postoperative methylprednisolone, and did not have postoperative analgesia. Multivariate logistic regression analysis showed that age (OR=1.111, 95% CI, 1.056-1.168), surgical timing (OR=1.154, 95% CI, 1.058-7.200), and use of methylprednisolone postoperatively (OR=8.030, 95% CI, 1.050-61.408) were risk factors. Use of Propofol intraoperatively (OR=0.315, 95%CI, 0.124-0.800) was protective factors for postoperative delirium in elderly critically ill patients.Conclusion: Adavanced age, COPD history, emergency surgery, postoperative hypertension, use of methylprednisolone, and no postoperative analgesia are risk factors for postoperative delirium in critically ill elderly patients. Medical staff should be educated in evaluating delirium in postoperative patients and conducting risk assessment in order to prevent and treat the disease earlier, and reduce the incidence of delirium.

scholarly journals Upper extremity deep vein thrombosis in COVID-19: Incidence and correlated risk factors in a cohort of non-ICU patients

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262522
Author(s):  
Nicola Mumoli ◽  
Francesco Dentali ◽  
Giulia Conte ◽  
Alessandra Colombo ◽  
Riccardo Capra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analyses ◽  
Univariate Analysis ◽  
Systematic Screening ◽  
Vein Thrombosis ◽  
Cpap Ventilation ◽  
Associated Risk Factors ◽  
Deep Vein ◽  
Pharmacological Thromboprophylaxis ◽  
Compression Ultrasonography

Background Venous thromboembolism is a frequent complication of COVID-19 infection. Less than 50% of pulmonary embolism (PE) is associated with the evidence of deep venous thrombosis (DVT) of the lower extremities. DVT may also occur in the venous system of the upper limbs especially if provoking conditions are present such as continuous positive airway pressure (CPAP). The aim of this study was to evaluate the incidence of UEDVT in patients affected by moderate-severe COVID-19 infection and to identify potential associated risk factors for its occurrence. Methods We performed a retrospective analysis of all patients affected by moderate-severe COVID-19 infection admitted to our unit. In accordance with the local protocol, all patients had undergone a systematic screening for the diagnosis of UEDVT, by vein compression ultrasonography (CUS). All the patients were receiving pharmacological thromboprophylaxis according to international guidelines recommendations. Univariate and multivariate analyses were used to identify risk factors associated with UEDVT. Results 257 patients were included in the study, 28 patients were affected by UEDVT with an incidence of 10.9% (95% CI, 7.1–14.7). At univariate analysis UEDVT appeared to be significantly associated (p< 0.05) with pneumonia, ARDS, PaO2/FiO2, D-dimer value higher than the age adjusted cut off value and need for CPAP ventilation. Multivariate analysis showed a significant association between UEDVT and the need for CPAP ventilation (OR 5.95; 95% IC 1.33–26.58). Increased mortality was found in patients affected by UEDVT compared to those who were not (OR 3.71; 95% CI, 1.41–9.78). Conclusions UEDVT can occur in COVID-19 patients despite adequate prophylaxis especially in patients undergoing helmet CPAP ventilation. Further studies are needed to identify the correct strategy to prevent DVT in these patients.

scholarly journals Symptomatic DVT One Month After TKA Was Associated With Tourniquet Reuse During Operation

2021 ◽  
Author(s):  
Jing Shen ◽  
Zhicheng Pan ◽  
Wangxin Liu ◽  
Yuan Tian ◽  
Weifeng Ji
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Multiple Factor Analysis ◽  
Vein Thrombosis ◽  
History Of ◽  
Total Knee ◽  
Independent Risk Factors ◽  
Deep Vein ◽  
Mean Time ◽  
Multiple Analysis

Abstract Background: DVT (Deep vein thrombosis) was one of the most common and sever complications after TKA (total knee arthroplasty). When tourniquet use and sometime the reuse was performed for surgery convenient of TKA. There was not sure if tourniquet use or reuse during operation would increase DVT after TKA.Methods: A retrospective study was performed about primarily TKA in our institute continuous 5 years. Univariate analysis was performed and potential intervention variables (P ≤ 0.1) were included in multiple factor analysis to certain the independent risk factors.Results: 807 patients (431 females and 376 males) were included with mean age was 65 years old. 3.84% (31 patients) were occurred sym-DVT (symptomatic DVT) one month after TKA with median time of diagnosis was 17 days. Incidence of sym-DVT after tourniquet reuse was significant high than once use and no use (7.25% versus 2.54% and 1.86%, P = 0.014 and 0.072), mean time of tourniquet use was 90.46 ± 14.28 mins in once and 106.58 ± 16.13 mins in reuse (P = 0.045). After multiple analysis, independent risk factors were revealed as history of tumor (P = 0.021), history of DVT (P < 0.001) and tourniquet reuse (P = 0.005).Conclusions: Tourniquet reuse was associated with highly incidence of sym-DVT other than history of tumor and DVT. There should be once use of tourniquet for prevent sym-DVT.

Risk factors for endovenous heat-induced thrombosis after endovenous radiofrequency ablation performed in Thailand

2016 ◽  
Vol 31 (8) ◽  
pp. 582-587 ◽  
Author(s):  
Nuttawut Sermsathanasawadi ◽  
Tsz Yin Voravitvet ◽  
Khamin Chinsakchai ◽  
Chumpol Wongwanit ◽  
Chanean Ruangsetakit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiofrequency Ablation ◽  
Operative Time ◽  
Univariate Analysis ◽  
Vein Thrombosis ◽  
Class 1 ◽  
Vein Diameter ◽  
Independent Risk Factors ◽  
Associated Risk Factors ◽  
Deep Vein

Objective We aimed to determine the incidence of and associated risk factors for endovenous heat-induced thrombosis (EHIT) after endovenous radiofrequency ablation (RFA). Methods We retrospectively reviewed the medical records of 82 patients with 97 great saphenous veins undergoing RFA from 2012 to 2014. Results The incidence of EHIT was 10.3%. Class 1, 2, and 3 EHIT was found in 50%, 30%, and 20% of legs, respectively. No class 4 EHIT, deep vein thrombosis, or pulmonary emboli occurred. Univariate analysis revealed that the associated risk factors for EHIT were a vein diameter of >10 mm, operative time of >40 min, and Caprini score of >6. Multivariate analysis revealed that the independent risk factors associated with EHIT were a vein diameter of >10 mm and operative time of >40 min. Conclusions A vein diameter of >10 mm and operative time of >40 min might be predictive factors for EHIT following RFA.

scholarly journals Risk Factors and Incidence of Deep Venous Thrombosis in Non-severe Coronavirus Disease-19 Patients

2021 ◽  
Vol 9 (B) ◽  
pp. 1446-1452
Author(s):  
Srdjan Babic ◽  
Aleksandar Babic ◽  
Milica Stojicic ◽  
Milena Gencic ◽  
Slobodan Tanaskovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Duplex Ultrasound ◽  
Severe Form ◽  
Multivariable Logistic Regression Analysis ◽  
Test Results ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
High Prevalence ◽  
Deep Vein

BACKGROUND: The coronavirus disease (COVID-19) is characterized by a high prevalence of deep vein thrombosis (DVT), particularly in its severe form, but the incidence of DVT and risk factors for DVT in non-severe patients are still unknown. METHODS: The study enrolled 118 patients with non-severe COVID-19 infection which did not required hospital admittance. A duplex ultrasound and laboratory test were performed in all the patients after the first negative polymerase chain reaction SARS-CoV-2 test. RESULTS: DVT was identified in 50 (42.4%) patients with a median age of 48 years (interquartile range 30–85 years). Symptomatic DVT was present in 40 (80%) patients and was commonly seen in the Class I calf vein thrombosis (38 patients, 76%) (χ2 = 51.71, p < 0.001). The most significant risk factors for DVT were as follows: Increased C-reactive protein (p = 0.000), fibrinogen (p = 0.000), low lymphocyte count (p = 0.002), obesity (p = 0.017), and neutrophil count (p = 0.042). The multivariable logistic regression analysis revealed that a D-dimer cutoff point of 1253.5 μg/L showed a sensitivity of 92% and a specificity of 71%. CONCLUSION: Patients with increased inflammatory markers and obese patients after a non-severe COVID-19 infection should have an ultrasound examination to ensure early diagnosis of DVT and to prevent the occurrence of any complications.

Features of Thrombi and Diagnostic Accuracy of Impedance Plethysmography in Symptomatic and Asymptomatic Deep Vein Thrombosis

1993 ◽  
Vol 70 (02) ◽  
pp. 266-269 ◽  
Author(s):  
Giancarlo Agnelli ◽  
Benilde Cosmi ◽  
Stefano Radicchia ◽  
Franca Veschi ◽  
Enrico Boschetti ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Diagnostic Accuracy ◽  
High Sensitivity ◽  
Impedance Plethysmography ◽  
Surveillance Programme ◽  
Vein Thrombosis ◽  
Asymptomatic Patients ◽  
High Prevalence ◽  
The Mean ◽  
Deep Vein

SummaryImpedance plethysmography (IPG) has high sensitivity and specificity in patients with symptomatic deep vein thrombosis (DVT) while it fails to detect asymptomatic DVT. The aim of this study was to determine whether the features of thrombi such as location, size and occlusiveness could explain the different accuracy of IPG in symptomatic and asymptomatic DVT patients. One-hundred and seventeen consecutive outpatients with a clinical suspicion of DVT and 246 consecutive patients undergoing hip surgery were admitted to the study. In symptomatic patients IPG was performed on the day of referral, followed by venography, while in asymptomatic patients IPG was performed as a surveillance programme, followed by bilateral venography.A venography proved DVT was observed in 37% of the symptomatic patients and 34% of the asymptomatic limbs. A significantly higher proportion of proximal DVTs was found in symptomatic patients than in asymptomatic patients (78% vs 46%; p = 0.001). The mean Marder score, taken as an index of thrombus size, was significantly higher in symptomatic patients than in asymptomatic patients (19.0 vs 9.6; p = 0.0001). A significantly higher proportion of occlusive DVTs was observed in symptomatic than in asymptomatic patients (69% vs 36%; p = 0.001).We conclude that the unsatisfactory diagnostic accuracy of IPG in asymptomatic DVT is due to the high prevalence of distal, small and non occlusive thrombi. Such thrombi are unlikely to cause a critical obstruction of the venous outflow and therefore to produce a positive IPG.

Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a retrospective study

2021 ◽  
Author(s):  
Miguel García-Boyano ◽  
José Manuel Caballero-Caballero ◽  
Marta García Fernández de Villalta ◽  
Mar Gutiérrez Alvariño ◽  
María Jesús Blanco Bañares ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Central Venous Access Device ◽  
Access Device ◽  
Vein Thrombosis ◽  
Venous Access Device ◽  
Deep Vein

scholarly journals Study on the Risk Factors of Preoperative Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

2021 ◽  
Vol 27 ◽  
pp. 107602962110029
Author(s):  
Wenjie Chang ◽  
Bin Wang ◽  
Qiwei Li ◽  
Yongkui Zhang ◽  
Wenpeng Xie
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Color Doppler ◽  
Fracture Site ◽  
Vein Thrombosis ◽  
Lower Extremity Fracture ◽  
Extremity Fracture ◽  
Deep Vein ◽  
D Dimer

Objective: The objective of this work is to discuss and analyze the related factors of lower extremity fracture complicated by preoperative deep vein thrombosis (DVT). Methods: A total of 11,891 patients with closed fractures of lower extremities were selected. By analyzing each patient’s gender, age, presence or absence of diabetes and hypertension, preoperative plasma D-dimer level, and color Doppler ultrasound of the lower extremity vein, the pertinent factors of the patients with lower extremity fractures complicated by preoperative DVT were analyzed. Results: A total of 578 with preoperative DVT were detected, displaying a total incidence of 4.86%. All patients were categorized into either the DVT group or non-DVT group. The results demonstrate that there were statistically significant differences between the 2 groups in age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level ( P < 0.05). Logistic multivariate analysis revealed that age, the presence of diabetes, and the preoperative plasma D-dimer level of patients were independent risk factors for lower extremity fracture complicated by DVT. Conclusion: Age, the presence of diabetes, the fracture site, and increased D-dimer levels were found to be potential risk factors and indicators for preoperative DVT in patients with lower extremity fractures. In addition, the preoperative plasma D-dimer level has certain guiding significance for the prediction of venous thrombosis after lower extremity fracture, which is conducive to the early prediction and diagnosis of DVT, but it often must be followed with good clinic acumen and examinations.

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