scholarly journals The outcome of isolated calf muscle vein thrombosis after open reduction and internal fixation for closed intra‐articular distal femur fractures: a prospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chen Chen ◽  
Ying Liu ◽  
Hengfu Wu ◽  
Jingmin Feng ◽  
Ao Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Open Reduction ◽  
Distal Femur ◽  
Vein Thrombosis ◽  
The Third ◽  
Femur Fractures ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background To observe the outcome of isolated calf muscle vein thrombosis (ICMVT) undergoing open reduction and internal fixation (ORIF) for closed intra-articular distal femur fractures (DFFs) and to analyze related factors. Methods The study was designed as a prospective clinical cohort study at our hospital. From August 2018 to August 2020,a total of 140 patients with flesh ICMVT after ORIF for closed intra-articular DFFs were collected during hospitalization. After the administration of antithrombotic agents immediately after diagnosis, the location and prognosis of postoperative ICMVT were examined by Duplex ultrasonography (DUS) with a three-month follow-up. There were 29 males and 111 females with the average age of 70.16 ± 8.75 years old. Sonography was used to evaluate the resolution of muscular vein thrombosis at the time point of the third month postoperatively and the results were compared between the two time points. Multivariable analysis was performed to evaluate the relationship between the resolution of ICMVT three months postoperatively and risk factors including age, Body Mass Index (BMI), gender, thrombosis length (> 5 / ≤5 cm), thrombosis diameter(> 0.6/≤0.6 cm), and thrombosis-related biochemistry indices. Results The postoperative ICMVTs was diagnosed at 5.47 ± 2.46 days after ORIF for closed intra-articular DFFs. At the follow up of 3 months,120 cases was tending to disappear with 88 cases(62.9 %) completely dissolved and 32 cases(22.9 %) partly dissolved. There existed 14 cases (10.0 %) without change on the size and 6 cases (4.2 %) with proximal propagation. Multivariate analysis revealed that thrombus diameter over 0.6 cm (odds ratio [OR], 8.900; 95 % confidence interval [CI]: 3.623–21.865), thrombus length over 5.0 cm (OR, 3.904; 95 % CI, 1.121–13.603), FIB over 3.0 g/L (OR, 3.627; 95 % CI, 1.356–9.689), and D-dimer over 1.0 mg/L (OR, 2.602; 95 % CI, 1.075–6.296) were four independent risk factors of non-completely dissolved ICMVTs. Conclusions 85.8 % of ICMVT was tending to disappear at the third months after ORIF for closed intra-articular DFFs. Thrombus diameter, thrombus length, FIB, and D-dimer were four independent risk factors of non-completely dissolved ICMVTs. The Thrombus diameter has a significant effect on the natural course of ICMVTs, especially with diameter larger than 0.6 cm.

scholarly journals Deep Vein Thrombosis in the Uninjured Limb in Patients with Lower Extremity Fractures: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Peng-Fei Wang ◽  
Jia-Hao Li ◽  
Chen Fei ◽  
Zhi Li ◽  
Chao Ke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Doppler Ultrasonography ◽  
Vein Thrombosis ◽  
Independent Risk Factors ◽  
Level 1 ◽  
Deep Vein ◽  
Actual Incidence ◽  
D Dimer

Objective. This study is aimed at investigating the incidence of deep vein thrombosis (DVT) in the uninjured limb during hospitalization and 1 month after surgery in patients with lower extremity fractures. Methods. We collected the clinical data of patients with lower extremity fractures in Xi’an Honghui Hospital. Doppler ultrasonography was used to diagnose DVT. According to the results of ultrasonography, the patients were divided into two groups: uninjured limb with DVT group and uninjured limb without DVT group. Results. A total of 494 patients who met all inclusion criteria were included in this study. The incidence rate of DVT in the uninjured limb was 19.84% and 18.83% during hospitalization and 1 month after surgery, respectively. Age (OR=1.035, 95% CI: 1.013–1.059; P=0.002) and D-dimer level 1 day after surgery (OR=1.065, 95% CI: 1.030–1.102; P<0.001) were independent risk factors for DVT during hospitalization. Similarly, age (OR=1.045, 95% CI: 1.021–1.070; P<0.001) and D-dimer level 1 day after surgery (OR=1.048, 95% CI: 1.014–1.083; P=0.006) were independent risk factors for DVT 1 month after surgery. During hospitalization and 1 month after surgery, 15.79% and 12.35% of patients had double lower limb thrombosis and 4.04% and 6.48% of patients had DVT in the uninjured limb only, respectively. Conclusion. The actual incidence of DVT in the uninjured limb in patients with lower extremity fractures cannot be ignored despite the use of anticoagulants for prevention or treatment during hospitalization. We should also be aware of DVT in the uninjured limb while focusing on DVT in the injured limb.

scholarly journals Features for deep vein thrombosis in the uninjured limbs of lower extremity fractures: a retrospective study 1454 patients

2020 ◽  
Author(s):  
Shuang-Wei Qu ◽  
Yu-Xuan Cong ◽  
Peng-Fei Wang ◽  
Chen Fei ◽  
Zhi Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Doppler Ultrasonography ◽  
Vein Thrombosis ◽  
Before And After ◽  
Independent Risk Factors ◽  
And Gender ◽  
Deep Vein ◽  
Actual Incidence ◽  
D Dimer

Abstract Objective: The purpose of this study was to investigate the incidence of and independent risk factors for deep venous thrombosis (DVT) in the uninjured limb, before and after operation, in patients with lower extremity fractures.Methods: We collected the clinical data of patients with lower extremities fractures who presented at Xi’an Honghui Hospital between 1 July, 2015 and 31 October, 2017. Doppler ultrasonography was used to diagnose the DVT. Patients were examined pre- and postoperatively. The patients were then divided into a thrombosis group and a no thrombosis group according to the preoperative and postoperative ultrasonography results. The thrombosis group was defined as patients admitted to our hospital with DVT in the uninjured limb and the no thrombosis group was defined as patients without DVT in the uninjured limb.Results: This study enrolled 1454 patients who met the inclusion criteria. The incidence of preoperative DVT in the uninjured limb was 9.63% whereas the postoperative incidence was 20.29%. Age (OR=0.965, 95 CI%: 0.954 - 0.977; P=0.000) and gender (OR=0.667, 95% CI: 0.451-0.986, P=0.042) were independent risk factors for preoperative DVT in the uninjured limb. Blood loss (OR=0.997, 95 CI%: 0.995-1.000; P=0.020), D-dimer levels at admission (OR=0.941, 95 CI%: 0.887-0.999; P=0.045), and postoperative day 5 D-dimer levels (OR=0.889, 95 CI%: 0.819-0.965; P=0.005), were independent risk factors for postoperative DVT in the uninjured limb.Conclusion: In conclusion, the actual incidence of DVT in the uninjured lower extremity after fracture may currently be underestimated and should be pay more attention.

scholarly journals Deep Vein Thrombosis in the Uninjured Limbs of Lower Extremity Fractures: A Retrospective Study of 1454 Patients

2020 ◽  
Author(s):  
Shuang-Wei Qu ◽  
Yu-Xuan Cong ◽  
Peng-Fei Wang ◽  
Chen Fei ◽  
Zhi Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Doppler Ultrasonography ◽  
Vein Thrombosis ◽  
Before And After ◽  
Independent Risk Factors ◽  
And Gender ◽  
Deep Vein ◽  
Actual Incidence ◽  
D Dimer

Abstract Objective: The purpose of this study was to investigate the incidence of deep venous thrombosis (DVT) in the uninjured limb, before and after operation, in patients with lower extremity fractures.Methods: We collected the clinical data of patients with lower extremities fractures who presented at Xi’an Honghui Hospital between 1 July, 2015 and 31 October, 2017. Doppler ultrasonography was used to diagnose the DVT. Patients were examined pre- and postoperatively. The patients were then divided into a thrombosis group and a no thrombosis group according to the preoperative and postoperative ultrasonography results. The thrombosis group was defined as patients admitted to our hospital with DVT in the uninjured limb and the no thrombosis group was defined as patients without DVT in the uninjured limb. Results: This study enrolled 1454 patients who met the inclusion criteria. The incidence of preoperative DVT in the uninjured limb was 9.63% whereas the postoperative incidence was 20.29%. Age (OR=0.965, 95 CI%: 0.954 - 0.977; P≤0.001) and gender (OR=0.667, 95% CI: 0.451-0.986, P=0.042) were independent risk factors for preoperative DVT in the uninjured limb. Blood loss (OR=0.997, 95 CI%: 0.995-1.000; P=0.020), D-dimer levels at admission (OR=0.941, 95 CI%: 0.887-0.999; P=0.045), and postoperative day 5 D-dimer levels (OR=0.889, 95 CI%: 0.819-0.965; P=0.005), were independent risk factors for postoperative DVT in the uninjured limb.Conclusion: In conclusion, the actual incidence of DVT in the uninjured lower extremity after fracture may currently be underestimated and should be pay more attention.

scholarly journals A Retrospective cohort study on the risk factors of deep vein thrombosis (DVT) for patients with traumatic fracture at Honghui Hospital

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024247 ◽  
Author(s):  
Wenjuan Zhang ◽  
Ying Huai ◽  
Wei Wang ◽  
Kaiyue Xue ◽  
Lei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Laboratory ◽  
Vein Thrombosis ◽  
Traumatic Fracture ◽  
Deep Vein ◽  
D Dimer

ObjectiveTo explore the risk factors of perioperative deep vein thrombosis (DVT) in patients with traumatic fracture after orthopaedic surgery and their potential diagnostic values in clinical.DesignRetrospective cohort study.SettingClinical Laboratory of Honghui Hospital, Xi’an JiaoTong University College of Medicine, Xi’an, Shaanxi, China.Materials and methodsA retrospective cohort study was conducted with surgically treated fracture patients in Honghui Hospital from 1 May 2016 to 31 February 2017.χ2test, independent sample t test and regression analysis were applied to examine the correlation between perioperative DVT and the factors of preoperative time, fracture sites, D-dimer value and chronic diseases (hypertension, diabetes and coronary disease).Results462 patients were enrolled for analysis. The preoperative time of patients with DVT was significantly longer than that of non-DVT patients (7.14±5.51 vs 5.45±3.75) (P<0.01).χ2test showed the significant differences in the rate of DVT among patients with different fracture sites (P<0.01). By the receiver-operating characteristic curve analysis, the cut-off value of preoperative D-dimer and postoperative D-dimer in diagnosing perioperative DVT was 4.01 µg/mL and 5.03 µg/mL, respectively. Area under the curve was 0.593 (95% CI 0.533 to 0.652) and 0.728 (95% CI 0.672 to 0.780), respectively. The sensitivity and specificity of preoperative D-dimer for DVT diagnosis were 71.30% and 44.83%, and as for postoperative D-dimer were 63.90% and 70.51%.ConclusionsFracture site was correlated to the incidence of DVT; prolonged preoperative time and increased D-dimer value were independent risk factors for DVT in patients with lower extremity traumatic fractures.

D-Dimer Level Significance for Deep Vein Thrombosis Screening in The Third Trimester : A Retrospective Study

2021 ◽  
Author(s):  
Keisuke Miyamoto ◽  
Hiroaki Komatsu ◽  
Masayo Okawa ◽  
Yuki Iida ◽  
Daiken Osaku ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Lower Limb ◽  
Third Trimester ◽  
Vein Thrombosis ◽  
The Third ◽  
Deep Vein ◽  
D Dimer ◽  
Compression Ultrasonography

Abstract BackgroundVenous thromboembolism often develops after surgery and childbirth, resulting in death in some cases. Although early deep vein thrombosis (DVT) detection can predict pulmonary thromboembolism, there is no early screening method for DVT in pregnant women. Lack of consensus regarding significance or setting and cut-off value interpretation of D-dimer levels further impedes venous thromboembolism screening in pregnant women.This study aimed to examine the utility of third-trimester serum D-dimer levels for screening test for DVT during pregnancy.to determine the frequency of asymptomatic DVT using lower-limb compression ultrasonography.MethodsThis single-center retrospective study included 497 pregnant women who underwent elective cesarean section at term in our hospital between January 2013 and December 2019. Serum D-dimer levels were preoperatively measured at 32–37 gestation weeks. The presence or absence of DVT in patients with serum D-dimer levels ≥ 3.0 µg/ml, the cut-off value, was examined using compression ultrasonography. In all patients, the presence or absence of clinical venous thrombosis (symptoms such as lower-limb pain, swelling, and heat sensation) was examined within 4 postoperative weeks.The Royal College of Obstetricians and Gynecologists Guideline 2015 was referred to determine risk factors for the onset of venous thrombosis during pregnancy. Among those, we examined the risk factors for DVT that result in high D-dimer levels during pregnancy.ResultsThe median age and body mass index were 35 (20–47) years and 21.2 (16.4–41.1) kg/m2, respectively. Further, the median gestational age and D-dimer levels were 37 weeks and 2.1 (0.2–16.0) µg/ml, respectively. Compression ultrasonography was performed on 135 (26.5%) patients with a D-dimer level ≥3.0 µg/ml, with none of the patients showing DVT. All patients were followed up for 4 postoperative weeks, with none presenting with venous thromboembolism. Multivariate analysis showed that hypertensive disorders of pregnancy is an independent risk factor for venous thromboembolism that causes high D-dimer levels (odds ratio: 2.48, 95% confidence interval: 1.05–6.50, P=0.04).ConclusionThere may be low utility in screening for DVT using D-dimer levels in the third trimester. Further, prepartum asymptomatic DVT has a low frequency, indicating the low utility of compression ultrasonography.Trial registrationInstitutional Review Board of Tottori University Hospital (IRB no. 20A149).

scholarly journals Renal dysfunction and prognosis of COVID-19 patients: a hospital-based retrospective cohort study

2020 ◽  
Author(s):  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
Jun Fei ◽  
Zheng Xu ◽  
Ling Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Cohort Study ◽  
Renal Dysfunction ◽  
Retrospective Cohort ◽  
Demographic Information ◽  
Multivariate Logistic Regression ◽  
Follow Up Study ◽  
Independent Risk Factors

Abstract Introduction: Increasing evidence indicate that coronavirus disease 2019 (COVID-19) is companied by renal dysfunction. However, the association of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-induced renal dysfunction with prognosis remains unclear.Materials and methods: This prospective case-cohort study analyzed 154 COVID-19 patients from the Second People’s Hospital of Fuyang City in Anhui Province. Clinical and demographic information were collected. Renal function was evaluated and its prognosis was followed up. Results: Of 154 hospitalized patients with COVID-19, 125 were common and 29 were severe patients. On admission, 16 (10.4%) patients were with renal dysfunction. Serum creatinine and cystatin C were increased, eGFR was decreased in severe patients compared with those in common patients. Renal dysfunction was more common in severe patients. By multivariate logistic regression, male, higher age and hypertension were three importantly independent risk factors of renal dysfunction in COVID-19 patients. Follow-up study found that at least one renal function marker of 3.33% patients remained abnormal in two weeks after discharge. Conclusion: Male elderly COVID-19 patients with hypertension elevates the risk of renal dysfunction. SARS-CoV-2-induced renal dysfunction are not fully recovered in two weeks after discharge.

scholarly journals Anti-PLA2R Antibodies Measured by ELISA Predict the Risk of Vein Thrombosis in Patients With Primary Membranous Nephropathy

2021 ◽  
Author(s):  
Huizi Zhu ◽  
Liang Xu ◽  
Xiang Liu ◽  
Bing Liu ◽  
Xiaowei Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Venous Thrombosis ◽  
Membranous Nephropathy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Multivariate Logistic Regression ◽  
Vein Thrombosis ◽  
Independent Risk Factors ◽  
Antibody Levels ◽  
D Dimer

Abstract BackgroundPrimary membranous nephropathy (PMN) is associated with the highest risk for developing venous thrombosis compared with other nephrotic diseases. The aim of the study was to assess the predictive value of the pathognomonic anti-PLA2R antibody with regard to incidence of venous thrombosis in PMN.Methods269 PMN patients with venous thrombosis examination were collected and analyzed. Anti-PLA2R antibodies were detected by commercial enzyme-linked immunosorbent assay. Multivariate Logistic regression was used to detect the independent risk factors for venous thrombosis.Results28 patients (10.4%) had venous thrombosis. Patients with venous thrombosis had higher levels of CHOL, LDL, and D-dimer than those without venous thrombosis (P<0.05). Patients with venous thrombosis had significantly lower levels of ALB (23.26 ± 5.24 vs. 26.00 ± 6.69 g/L, P=0.037). No significant differences were found in urine proteinuria, SCR, eGFR, platelets and fibrinogen between patients with and without thrombosis. Anti-PLA2R antibody levels in patients with venous thrombosis were significantly higher than in patients without it (P=0.010). In the univariate logistic regression, Ln PLA2R (OR: 1.316; P=0.032), ALB (OR: 0.932; P=0.039), CHOL (OR: 1.189, P=0.015) , and LDL (OR: 1.288，P=0.009) were associated with venous thrombosis. PLA2R-Ab (OR=1.316; 95%CI: 1.024~1.691), and LDL (OR=1.229; 95%CI: 1.012~1.493) were the independent risk factors for venous thrombosis (P<0.05) in multivariate analysis.ConclusionAnti-PLA2R antibody was the independent risk factor for venous thrombosis in PMN. Larger prospective studies were warranted to verify the results in future.

Risk factors for venous thromboembolism (VTE) in outpatients with pancreatic cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14578-e14578
Author(s):  
Joshua Michael Ruch ◽  
Michelle A Anderson ◽  
Suman Lata Sood
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Regression Analysis ◽  
Cohort Study ◽  
Platelet Count ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Comprehensive Cancer Center ◽  
Vein Thrombosis

e14578 Background: The incidence of VTE is increased in pancreatic cancer. Predictive models for cancer-associated VTE have been developed, but none specific for the pancreas. Our primary objective was to identify risk factors for VTE in outpatients with pancreatic cancer. Secondary objective was to develop a predictive model. Methods: Patients seen at the University of Michigan Comprehensive Cancer Center (UMCC) and previously consented and enrolled in a prospective cohort study were eligible. Inclusion criteria included a diagnosis of pancreatic adenocarcinoma, evaluation at UMCC, and follow up in the Electronic Medical Record (EMR) at least every 6 months. Demographics, clinical data, and VTE events (defined as deep vein thrombosis [DVT], portal vein thrombosis [PVT], or pulmonary embolism [PE]) were obtained from the EMR. A retrospective cohort study was performed including univariate and multivariate regression analysis. Results: Between 2005 and 2011, 92 patients were eligible for analysis. Median follow-up was 263.5 (18-2433) days. Twenty (21.7%) patients had a VTE; 10 (50%) DVT, 2 (10%) PE, 4 (20%) PVT, and 4 (20%) multiple VTEs. Mean (SD) age was 63.4 (8.9) with and 65.6 (11.8) without VTE. 55% of patients with and 47% without VTE were women. Higher body mass index (BMI) (median 28.8 [21.2-44.7] vs. 25.5 [16.4-43.3], p=0.02) and lower platelet count (median 241 [145-323] vs. 288 [75-645], p=0.04) were associated with VTE in univariate analysis. In multivariate regression analysis, lower platelet count (β -0.01, SE 0.004) and lower hemoglobin (β -0.44, SE 0.20) were predictive of VTE after adjusting for BMI, tumor location, and treatment with surgery, chemotherapy or radiation (area under the ROC curve 0.78). Conclusions: Pancreatic cancer outpatients with higher BMI, lower platelet count, and lower hemoglobin were more likely to develop VTE. Other clinical variables did not add additional predictive information. Given the small magnitude of difference, basic clinical criteria alone may be inadequate to identify patients at highest risk for developing VTE who may benefit from thromboprophylaxis. Additional studies are warranted to further define risk factors for VTE in this population, including novel biomarkers.

Sign in / Sign up

Export Citation Format

Share Document