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Cui X, Xia R, Chao A. Correlation between ABO blood type and lower extremity deep vein thrombosis in elderly patients following hip fracture. Am J Transl Res 2024; 16:2654-2661. [PMID: 39006278 PMCID: PMC11236633 DOI: 10.62347/wkya9182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To examine the correlation between ABO blood type and the incidence of lower extremity deep vein thrombosis (LEDVT) in elderly patients after hip fracture surgery, while identifying contributing factors to thrombogenesis. METHODS We conducted a retrospective analysis of 159 elderly patients with hip fractures treated at Tianjin Hospital (Affiliated Hospital of Tianjin University) from December 2021 to December 2023. The cohort was divided into two groups: those with O blood type (45 patients) and those with non-O blood types (114 patients). We analyzed clinical data and the incidence of LEDVT between the groups. Logistic regression was used to identify independent risk factors for LEDVT, and receiver operator characteristic (ROC) curve analysis evaluated the predictive efficacy of these factors. RESULTS The incidence of LEDVT was significantly higher in the non-O blood type group compared to the O blood type group (34.21% vs. 15.56%, P = 0.0408). Logistic regression identified high body mass index (BMI), comorbid hypertension, low platelet count (PLT), prolonged prothrombin time (PT), and non-O blood type as independent risk factors for LEDVT. The ROC curve for these predictors showed an area under the curve of 0.862, with a sensitivity of 75.22%, a specificity of 86.96%, and an accuracy of 78.62%. CONCLUSION ABO blood type is correlated with the occurrence of LEDVT in elderly patients' post-hip fracture. Those with non-O blood type, alongside other factors such as high BMI, hypertension, low PLT, and extended PT, are at increased risk of developing LEDVT.
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Affiliation(s)
- Xiuli Cui
- Department of Osteo-Internal Medicine, Tianjin Hospital (Affiliated Hospital of Tianjin University) No. 406 Jiefang South Road, Hexi District, Tianjin 300211, China
| | - Ronglin Xia
- Department of Osteo-Internal Medicine, Tianjin Hospital (Affiliated Hospital of Tianjin University) No. 406 Jiefang South Road, Hexi District, Tianjin 300211, China
| | - Aijun Chao
- Department of Osteo-Internal Medicine, Tianjin Hospital (Affiliated Hospital of Tianjin University) No. 406 Jiefang South Road, Hexi District, Tianjin 300211, China
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Lv B, Wang H, Zhang Z, Li W. Distribution characteristics of perioperative deep vein thrombosis (DVT) and risk factors of postoperative DVT exacerbation in patients with thoracolumbar fractures caused by high-energy injuries. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02468-0. [PMID: 38416184 DOI: 10.1007/s00068-024-02468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/01/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To investigate the distribution characteristics of perioperative deep venous thrombosis (DVT) in patients with thoracolumbar fractures caused by high-energy injuries and analyze the risk factors of postoperative DVT exacerbation. METHODS From October 2016 to July 2021, a total of 550 patients with thoracolumbar fractures due to high-energy injuries in our hospital were retrospectively analyzed. Both lower limbs were examined by ultrasound before and after operation. Depending on whether the postoperative DVT was exacerbating, the group was divided into a DVT exacerbation group and a non-DVT exacerbation group. Clinical data were used to study the characteristics of perioperative DVT. Logistic regression analysis and receiver operating characteristic (ROC) curve were used to explore the risk factors of postoperative DVT exacerbation. RESULTS DVT was found in 97 patients before operation, including 78 cases of distal thrombus, 6 cases of proximal thrombus, and 13 cases of mixed thrombus. Postoperative DVT increased to 116, including 87 distal thrombus, 10 proximal thrombus, and 19 mixed thrombus. The intermuscular vein was the most easily involved vein. Compared with lumbar fractures, thoracic fractures were more likely to have postoperative proximal thrombus (P=0.014). There were 48 cases of thrombus exacerbation after operation. Logistic regression analysis revealed that age, lower extremity muscle strength, time from injury to operation, and blood loss were risk factors for postoperative DVT exacerbation. CONCLUSIONS The intermuscular vein is the most easily involved vein. The anatomical distribution of DVT at different fracture sites is different, and patients with thoracic fractures are more likely to have proximal DVT after operation. Age, lower extremity muscle strength, time from injury to operation, and blood loss were risk factors for postoperative DVT exacerbation.
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Affiliation(s)
- Bing Lv
- Department of Ultrasound Medicine, Baoding No.1 Central Hospital, Baoding, 071000, People's Republic of China
| | - Haiying Wang
- Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, 320 Changcheng North Street, Baoding, Hebei, 071000, People's Republic of China.
| | - Zipeng Zhang
- Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, 320 Changcheng North Street, Baoding, Hebei, 071000, People's Republic of China
| | - Weifeng Li
- Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, 320 Changcheng North Street, Baoding, Hebei, 071000, People's Republic of China
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Jiao Y, Mu X. Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures. J Orthop Surg Res 2023; 18:928. [PMID: 38057818 DOI: 10.1186/s13018-023-04407-y] [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: 10/23/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) is one of the leading causes of mortality in hospitalized patients. However, whether the coagulation-related parameters of the hospitalized patients could be used to predict the occurrence of VTE in patients with spinal injury surgery remained unclear. METHOD The patients with spinal fractures who met the inclusion and exclusion criteria were enrolled to be analyzed using a retrospective analysis approach. The association of risk factors of enrolled patients and operations to VTE occurrence were analyzed. The activated partial thromboplastin time, prothrombin time, thrombin time, D-dimer (D-D), fibrinogen (FIB) and fibrinogen degradation products (FDP) were detected. ROC and HR analysis were applied to evaluate the correlation of coagulation-related parameters and other parameters to VTE occurrence. RESULT The indicators of D-D, FIB and FDP were significantly elevated in VTE patients compared to non-VTE patients. The multivariate analysis of OR showed that six risk factors, including age ≥ 60, spinal cord injury, postoperative bedtime over 5 days, plasma D-dimer ≥ 0.54 mg/L, plasma fibrinogen ≥ 3.75 g/L and plasma FDP ≥ 5.19 mg/L, were positively correlated to VTE. CONCLUSION The six risk factors, including D-D, FIB, FDP, age ≥ 60, spinal cord injury, and postoperative bedtime over 5 days, could be used to predict the occurrence of VTE.
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Affiliation(s)
- Yong Jiao
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, No. 5 Haihai Warehouse, Dongzhimen, Beijing, 100000, China
| | - Xiaohong Mu
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, No. 5 Haihai Warehouse, Dongzhimen, Beijing, 100000, China.
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Wang BH, Sun YD, Fan XC, Zhang BF. The admission pH is a risk factor of preoperative deep vein thrombosis in geriatric hip fracture: a retrospective cohort study. Sci Rep 2023; 13:18392. [PMID: 37884624 PMCID: PMC10603124 DOI: 10.1038/s41598-023-45712-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023] Open
Abstract
This study evaluated the association between body pH value and preoperative deep vein thrombosis (DVT) in geriatric hip fractures. Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of the patients were collected. Multivariate binary logistic regression and generalized additive models were used to identify the linear and nonlinear associations between pH value and preoperative DVT. Analyses were performed using EmpowerStats and R software. A total of 1465 patients were included in the study. DVT occurred in 476 (32.6%) of these admitted older adults. We observed a nonlinear association between the serum pH value and preoperative DVT in geriatric patients with hip fractures. A pH value of 7.39 was the inflection point in the curve, with pH highly correlated with DVT at pH < 7.39 (odds ratio [OR] 19.47; 95% confidence interval [CI] 1.45-260.91; P = 0.0249). Patients with lower pH had a lower chance of preoperative DVT formation, and the risk of DVT increased 18.47-fold for every 0.1 unit change in pH. Although at pH > 7.39, pH was not correlated with DVT (OR 1.26; 95% CI 0.85-1.86; P = 0.2561), the odds of DVT did not vary with pH, and the highest risk of thrombosis was reached. The body pH value is nonlinearly associated with preoperative DVT in geriatric patients with hip fractures, and it could be considered a predictor of the risk of DVT.Registered information This study is registered in the website of Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).
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Affiliation(s)
- Bao-Hui Wang
- Pain Area of Rehabilitation Hospital, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Yin-Di Sun
- Pain Area of Rehabilitation Hospital, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Xiao-Chen Fan
- Pain Area of Rehabilitation Hospital, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Bin-Fei Zhang
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, 710054, Shaanxi Province, China.
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Xiang G, Dong X, Lin S, Cai L, Zhou F, Luo P, Zhu J. A nomogram for prediction of deep venous thrombosis risk in elderly femoral intertrochanteric fracture patients: A dual-center retrospective study. Front Surg 2023; 9:1028859. [PMID: 36684366 PMCID: PMC9852608 DOI: 10.3389/fsurg.2022.1028859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/25/2022] [Indexed: 01/07/2023] Open
Abstract
Objective Deep venous thrombosis (DVT) of the lower extremity is a common perioperative complication of femoral intertrochanteric fracture. This study aimed to identify the risk factors of lower extremity deep vein thrombosis (DVT) in elderly femoral intertrochanteric fracture patients and establish a nomogram model. Methods From August 2014 to June 2021, a total of 1,652 femoral intertrochanteric fracture patients over the age of 65 were enrolled in our study. We distinguished independent risk factors by univariate and multivariate Cox analyses. A nomogram model was then built, and the discriminative and calibration of the model was evaluated through receiver operating characteristics (ROC) and calibration plots. Results A total of 378 patients developed DVT (292 in the training group, 86 in the validation group) while the remaining patients did not. According to the univariate and multivariate Cox analyses results, age (OR = 1.07, 95% CI: 1.04-1.10), fibrinogen (OR = 2.09, 95% CI: 1.68-2.60), D-dimer (OR = 1.33, 95% CI: 1.27-1.40), time from injury to admission (OR = 1.78, 95% CI: 1.55-2.05), functional status (OR = 4.21, 95% CI: 2.86-6.20), and diabetes (OR = 1.65, 95% CI: 1.10-2.48) were identified as independent risk factors of DVT. The ROC values for DVT of the training and validation group were 0.862 and 0.912, and the P-value of the Hosmer-Lemeshow calibration test was 0.767. Conclusion This nomogram model can be used to predict the probability of preoperative DVT in elderly patients with femoral intertrochanteric fracture and guide physician in perioperative thrombosis management.
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Affiliation(s)
- Guangheng Xiang
- Department of Orthopaedic, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyu Dong
- School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, China
| | - Shenglei Lin
- Department of Orthopaedic, Wenzhou Central Hospital, Wenzhou, China
| | - Leyi Cai
- Department of Orthopaedic, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Feiya Zhou
- Department of Orthopaedic, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peng Luo
- Department of Orthopaedic, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Juanjuan Zhu
- Department of Geriatrics and Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China,Correspondence: Juanjuan Zhu
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The Association between the Hematocrit at Admission and Preoperative Deep Venous Thrombosis in Hip Fractures in Older People: A Retrospective Analysis. J Clin Med 2023; 12:jcm12010353. [PMID: 36615152 PMCID: PMC9821762 DOI: 10.3390/jcm12010353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Hematocrit, a commonly used hematological indicator, is a simple and easily applicable test. As a marker of anisocytosis and anemia, it indicates the percentage of blood cells per unit volume of whole blood. This study aimed to evaluate the association between the level of the hematocrit at admission and preoperative deep vein thrombosis (DVT) in hip fractures of older people. We collected the demographic and clinical characteristics of patients with geriatric hip fractures between 1 January 2015, and 30 September 2019, at the largest trauma center in northwestern China. Doppler ultrasonography was used to diagnose DVT. The correlation between hematocrit levels at admission and preoperative DVT was assessed using linear and nonlinear multivariate logistic regression, according to the adjusted model. All analyzes were performed using EmpowerStats and R software. In total, 1840 patients were included in this study, of which 587 patients (32%) had preoperative DVT. The mean hematocrit level was 34.44 ± 5.64 vol%. Linear multivariate logistic regression models showed that admission hematocrit levels were associated with preoperative DVT (OR = 0.97, 95% CI: 0.95−0.99; p = 0.0019) after adjustment for confounding factors. However, the linear association was unstable, and nonlinearity was identified. An admission hematocrit level of 33.5 vol% was an inflection point for the prediction. Admission hematocrit levels <33.5 vol% were not associated with preoperative DVT (OR = 1.00, 95% CI: 0.97−1.04, p = 0.8230), whereas admission hematocrit levels >33.5 vol% were associated with preoperative DVT (OR = 0.94, 95% CI: 25 0.91−0.97, p = 0.0006). Hematocrit levels at admission were nonlinearly associated with preoperative DVT, and hematocrit at admission was a risk factor for preoperative DVT. However, the severity of a low hematocrit was not associated with preoperative DVT when the hematocrit was <33.5 vol%.
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Kobayashi T, Akiyama T, Mawatari M. Predictors of preoperative deep vein thrombosis in hip fractures: A systematic review and meta-analysis. J Orthop Sci 2023; 28:222-232. [PMID: 34593286 DOI: 10.1016/j.jos.2021.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The predictors of preoperative deep vein thrombosis (DVT) in patients with hip fractures remain unclear. Therefore, this study describes the results of a systematic review and meta-analysis of relevant peer-reviewed literature on this topic. METHODS We searched PubMed, Google Scholar, Cochrane Library, Web of Science, and MEDLINE for articles published in English on the predictors of preoperative DVT in hip fractures. We calculated pooled odds ratios (OR) or mean differences (MD) for the DVT groups as compared with the non-DVT groups for each variable, including gender, age, body mass index, injury side, current smoking status, time from injury to admission, time from injury to surgery, fracture type, hypertension, arrhythmia, coronary artery disease, diabetes, stroke, kidney disease, liver disease, lung disease, malignancy, rheumatoid arthritis, D-dimer, fibrinogen, activated partial thromboplastin time, prothrombin time, thrombin time, hemoglobin, albumin, total cholesterol, and triglycerides. RESULTS We included 9 studies involving 3,123 Asian patients with hip fractures (DVT, n = 570; non-DVT, n = 2,553). Being female (OR = 1.27; 95% confidence interval [CI] 1.04-1.56; p = 0.02), being of advanced age (MD = 1.63; 95% CI 0.80-2.47; p = 0.0001), having a longer time from injury to admission (MD = 0.80; 95% CI 0.48-1.12; p < 0.00001), having a longer time from injury to surgery (MD = 2.20; 95% CI 1.53-2.88; p < 0.00001), and the presence of kidney disease (OR = 1.76; 95% CI 1.04-2.96; p = 0.03) were correlated with a high risk of DVT. However, we found no significant differences between the two groups in the other predictors. CONCLUSIONS Evidence indicates that being female, being of advanced age, having a longer time from injury to admission, having a longer time from injury to surgery, and having kidney disease are significantly correlated with a high risk of preoperative DVT in Asian patients with hip fracture. Further investigations with patients of other ethnicities are required.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Imari-Arita Kyoritsu Hospital, 860 Ninosekou Arita-Town Nishimatsuura-Gun, Saga 849-4141, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
| | - Takayuki Akiyama
- Department of Orthopaedic Surgery, Imari-Arita Kyoritsu Hospital, 860 Ninosekou Arita-Town Nishimatsuura-Gun, Saga 849-4141, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
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Wang X, Jiang Z, Li Y, Gao K, Gao Y, He X, Zhou H, Zheng W. Prevalence of preoperative Deep Venous Thrombosis (DVT) following elderly intertrochanteric fractures and development of a risk prediction model. BMC Musculoskelet Disord 2022; 23:417. [PMID: 35509097 PMCID: PMC9065244 DOI: 10.1186/s12891-022-05381-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/15/2022] [Indexed: 01/01/2023] Open
Abstract
Background This study aimed to investigate the prevalence of preoperative deep venous thrombosis (DVT) following intertrochanteric fractures in the elderly and identify the associated factors, based on which a risk prediction model was developed. Method This was a retrospective single-center study of elderly patients presenting with intertrochanteric fractures between our institution between January 2017 and December 2020. Patients' duplex ultrasound (DUS) or venography results were retrieved to evaluate whether they had a preoperative deep venous thrombosis (DVT) of bilateral extremities, whereby patients were dichotomized. Various variables of interest on demographics, comorbidities, injury and biomarkers were extracted and their relationship between DVT were investigated. Statistically significant variables tested in multivariate logistics regression analyses were used to develop a risk prediction model. Results There were 855 patients eligible to be included in this study, and 105 were found to have preoperative DVT, with a prevalence rate of 12.3%. Ten factors were tested as significantly different and 2 marginally significant between DVT and non-DVT groups in the univariate analyses, but only 6 demonstrated the independent effect on DVT occurrence, including history of a VTE event (OR, 4.43; 95%CI, 2.04 to 9.62), time from injury to DVT screening (OR, 1.19; 95%CI, 1.13 to 1.25), BMI (OR, 1.11; 95%CI, 1.04–1.18), peripheral vascular disease (OR, 2.66; 95%CI, 1.10 to 6.40), reduced albumin (2.35; 95%CI, 1.48 to 3.71) and D-Dimer > 1.0 mg/L(OR, 1.90; 95%CI, 1.13 to 3.20). The DVT risk model showed an AUC of 0.780 (95%CI, 0.731 to 0.829), with a sensitivity of 0.667 and a specificity of 0.777. Conclusion Despite without a so high prevalence rate of DVT in a general population with intertrochanteric fracture, particular attention should be paid to those involved in the associated risk factors above. The risk prediction model exhibited the improved specificity, but its validity required further studies to verify.
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Affiliation(s)
- Xiaofei Wang
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Zhen Jiang
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Yufu Li
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Kai Gao
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Yang Gao
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Xiaoli He
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Hongyan Zhou
- Department of Nursing, the 3Rd Hospital of Shijiazhuang, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Wei Zheng
- Department of Traditional Chinese Medicine Orthopaedics, the 3Rd Hospital of Shijiazhuang, NO.15 Tiyu South Street, Shijiazhuang, 050000, Hebei, People's Republic of China.
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Construction of Prediction Model of Deep Vein Thrombosis Risk after Total Knee Arthroplasty Based on XGBoost Algorithm. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3452348. [PMID: 35116072 PMCID: PMC8807042 DOI: 10.1155/2022/3452348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/14/2021] [Accepted: 12/31/2021] [Indexed: 11/19/2022]
Abstract
Objective Based on the XGBoost algorithm, the prediction model of the risk of deep vein thrombosis (DVT) in patients after total knee arthroplasty (TKA) was established, and the prediction performance was compared. Methods A total of 100 patients with TKA from January 2019 to December 2020 were retrospectively selected as the study subjects and randomly divided into a training set (n = 60) and a test set (n = 40). The training set data was used to construct the XGBoost algorithm prediction model and to screen the predictive factors of postoperative DVT in TKA patients. The prediction effect of the model was evaluated by using the test set data. An independent sample T-test was used for comparison between groups, and the χ2 test was used for comparison between counting data groups. Results The top five items were combined with multiple injuries (35 points), time from injury to operation (28 points), age (24 points), combined with coronary heart disease (21 points), and D-dimer 1 day after operation (16 points). In the training set, the area under the curve of the XGBoost algorithm model was 0.832 (95% CI: 0.748-0.916). Conclusion The model based on the XGBoost algorithm can predict the incidence of DVT in patients after TKA with good performance.
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Cong Y, Huang H, Zhang BF, Deng H, Lei J, Ke C, Han S, Zhang K, Wang P. The Correlation Between Preoperative Lower Extremity Deep Vein Thrombosis (DVT) and the Time from Injury to Surgery (TFITS). Clin Appl Thromb Hemost 2022; 28:10760296221108961. [PMID: 35850538 PMCID: PMC9309766 DOI: 10.1177/10760296221108961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the correlation between preoperative DVT and the time from
injury to surgery (TFITS), and provide a clinical reference for the
prevention of preoperative DVT. Patients and methods We collected the clinical data of patients with lower extremities fractures
between September 1, 2014, and May 31, 2019. Doppler ultrasonography was
used to diagnose DVT. Patients were divided into the 0-2d group, 3-4d group,
5-7d group, and >7d group according to TFITS. The correlation between
TFITS and preoperative DVT was assessed using logistic regression according
to the adjusted model. Result A total of 2831 patients were included in the study. The mean(+/-SD) TFITS
was 6.11 ± 3.76 (0 to 21 d). A total of 821 (29.0%) cases had preoperative
DVT, with the incidence of DVT being 8.0% in the 0-2d group, 23.8% in the
3-4d group, 32.0% in the 5-7d group, and 36.2% in the >7d group, with
statistically significant differences(P<0.05) among all the groups. The
incidence of preoperative DVT increased with prolonged preoperative time. In
the fully adjusted model, TFITS was positively correlated with the incidence
of preoperative DVT (OR: 1.093; 95% CI: 1.068-1.118; P = 0.000), and the
strength of the association increased with increasing time. Conclusion TFITS was an independent risk factor on the incidence of preoperative DVT.
After excluding the effect of other factors, each 1d increases in TFITS was
correlated with a 9.3% increase in the risk of preoperative DVT. The TFITS
should be decreased to reduce the risk of preoperative DVT.
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Affiliation(s)
- Yuxuan Cong
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Hai Huang
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Bin-Fei Zhang
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Hongli Deng
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Jinlai Lei
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Chao Ke
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Shuang Han
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Kun Zhang
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
| | - Pengfei Wang
- Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi Province, 710054, People's Republic of China
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Zhou FL, Wang LH, Dai CQ, Shentu GJ, Xu GH. Risk Factors and Outcomes for Preoperative Asymptomatic Pulmonary Embolism in Patients Aged 60 Years and Over with Hip Fracture. Orthop Surg 2021; 13:958-965. [PMID: 33818010 PMCID: PMC8126953 DOI: 10.1111/os.12983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the risk factors for, and outcomes of, preoperative asymptomatic pulmonary embolism (PE) in patients ≥60 years old following delayed operation for hip fracture. Methods From March 2017 to December 2018, 90 patients aged ≥60 years with hip fracture who suffered a delay in surgery were recruited to this prospective study following admission to our hospital. Computed tomography pulmonary angiography (CTPA) was used to detect preoperative asymptomatic PE and calculated its incidence. Time from injury to admission, baseline characteristics, medical comorbidities, and blood biomarker levels were evaluated as potential risk factors. Logistic regression analysis was used to identify risk factors. Mortality and major bleeding events were recorded and compared between individuals with PE and without. Data were analyzed by t‐test, Mann–Whitney U test, χ2 test, Fisher's exact test, and logistic regression analysis. Results The incidence of preoperative asymptomatic PE was 18.9% (17/90 patients). In the univariate analysis, the risk factors for preoperative asymptomatic PE were male sex, hypertension, cerebrovascular accident, smoking, plasma D‐dimer level, potassium level, urea level, creatinine level, and cysteine level. Multivariate logistic regression analysis showed that the risk of preoperative asymptomatic PE was higher in patients with hypertension (odds ratio [OR] = 10.048; 95% confidence interval [CI], 1.118–90.333), cerebrovascular accident (OR = 20.135; 95% CI, 1.875–216.164), smoking (OR = 48.741; 95% CI, 4.155–571.788), high plasma D‐dimer levels (OR = 1.200; 95% CI, 1.062–157.300), and high plasma potassium levels (OR = 12.928; 95% CI, 1.062–157.300). All patients were followed up for 21.0 months (range, 2 to 36 months). Mortality within the first year postoperatively was higher in patients with PE (29.41% vs 9.59%, P = 0.046). Conclusions In view of the high incidence of preoperative asymptomatic PE and the inferior prognosis in individuals with PE, routine CTPA examination for preoperative asymptomatic PE could be useful for patients aged ≥60 years with hip fracture for whom surgery is delayed.
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Affiliation(s)
- Fang-Lun Zhou
- Department of Arthrology, Dongyang People's Hospital, Wenzhou Medical University Affiliated Dongyang Hospital, Dongyang, China
| | - Li-Hong Wang
- Department of Arthrology, Dongyang People's Hospital, Wenzhou Medical University Affiliated Dongyang Hospital, Dongyang, China
| | - Cheng-Qian Dai
- Department of Arthrology, Dongyang People's Hospital, Wenzhou Medical University Affiliated Dongyang Hospital, Dongyang, China
| | - Guo-Jian Shentu
- Department of Arthrology, Dongyang People's Hospital, Wenzhou Medical University Affiliated Dongyang Hospital, Dongyang, China
| | - Guo-Hong Xu
- Department of Arthrology, Dongyang People's Hospital, Wenzhou Medical University Affiliated Dongyang Hospital, Dongyang, China
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Yoon JY, Kim S, Chang JS, Yoon PW, Kim JW. Venous thromboembolism after delayed surgery for a hip fracture: A retrospective cohort study. Geriatr Gerontol Int 2020; 20:1151-1156. [PMID: 33058481 DOI: 10.1111/ggi.14055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 01/14/2023]
Abstract
AIM The purpose of this study was to investigate the demographic characteristics and prevalence of postoperative venous thromboembolism (VTE) in delayed hip fracture patients referred to our hospital (a tertiary referral center), and further verify the effect of intensive prophylaxis protocol in preventing the occurrence of VTE. METHODS We retrospectively evaluated 264 hip fracture patients whose surgery was delayed by >24 h. The patients were divided into two groups, according to the VTE prophylaxis protocol (conventional vs intensive). We evaluated the time from injury to surgery, and analyzed the prevalence of postoperative symptomatic VTE between the groups. The patient outcome measures, including in-hospital mortality and 30-day-mortality after hip surgery, were also evaluated. RESULTS The mean time from injury to operation was 127.4 h (95% confidence interval 92.2-162.7 h). The incidence of postoperative symptomatic VTE was 5.9% in the conventional prophylaxis group and 0.8% in the intensive prophylaxis group. The intensive prophylaxis group had a significantly lower incidence of postoperative VTE (P = 0.036). Eight patients with deep vein thrombosis on preoperative screening who underwent inferior vena cava filter insertion did not develop postoperative symptomatic VTE. Logistic regression analysis results also showed that the protocol statistically reduced the development of VTE (odds ratio 0.14, 95% CI 0.02-1.21, P = 0.042). CONCLUSIONS Delayed hip fracture surgery resulted in a higher incidence of VTE in patients who received conventional prophylaxis; however, our intensive prophylaxis protocol successfully prevented postoperative symptomatic VTE, including pulmonary embolism. Geriatr Gerontol Int 2020; 20: 1151-1156.
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Affiliation(s)
- Jae Youn Yoon
- Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Shinseok Kim
- Department of Orthopaedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae Suk Chang
- Department of Orthopaedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Pil Whan Yoon
- Department of Orthopaedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ji Wan Kim
- Department of Orthopaedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Effects of a fast track surgery nursing program in perioperative care of older patients with a hip fracture. Eur Geriatr Med 2020; 11:519-525. [DOI: 10.1007/s41999-020-00298-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/07/2020] [Indexed: 12/14/2022]
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